Abstract
Invasive coronary arteriography (ICA) is the most important test for the diagnosis of ischaemic heart disease. It is essential to know its indications and the different additional tests that can be performed during cardiac catheterisation. The indications for ICA are a very high clinical likelihood of ischaemic heart disease with high-risk characteristics or extensive areas of ischaemia on non-invasive tests. Invasive functional testing is indicated for angiographically borderline lesions, such as fractional flow reserve. If there are no angiographically significant lesions, we must rule out microvascular dysfunction with tests such as coronary flow reserve. We must also rule out vasospastic angina with vasospasm provocation testing.
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