Abstract
Coronary artery disease (CAD) is the leading cause of morbidity and mortality in developed countries.1 The reatment of CAD has been revolutionized during the past everal decades; however, appropriate patient selection for reatment is of paramount importance. Treatment of CAD, hether by medical therapy or revascularization, depends on variety of factors including patients’ symptoms, long-term isk and likelihood of procedural success. Key diagnostic ests add to the history and physical examination in guiding reatment. The traditional cornerstone of CAD assessment ad been stress testing, either with electrocardiography EKG) alone or in combination with echocardiography or uclear scintigraphy. Although counterintuitive, it is now accepted that detecion of anatomical CAD does not imply hemodynamically ignificant disease that requires revascularization. Stress testng provides data on the physiology of CAD. Recent advanceents in computed tomography angiography (CTA) and ardiac magnetic resonance imaging (MR) have provided cliicians with alternative diagnostic tools. CTA and MR both rovide functional and anatomical data, yet each modality as its own strengths and weaknesses. CTA noninvasively rovides detailed anatomical information but requires ionizng radiation. MR’s strength lies in improved functional data nd myocardial tissue characterization but has long scan imes and limitations imposed by claustrophobia and MRncompatible implants. Both modalities have shown technial advances in mitigating the limitations of irregular cardiac hythms, breath holding difficulty, and extensive calcium or etallic artifacts.
Published Version
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