Few diagnostic methods in Cardiology have heralded such
revolutionary developments as the introduction of coronary
arteriography. When, in the early 1960's, Dr. F. Mason Sones
demonstrated that visualization of the coronary anatomy in living
humans was not only feasible but sufficiently safe and reliable to
be used as a clinical tool in the evaluation of patients with known
or suspected ischemic heart disease, the thus far somewhat
neglected area of coronary circulation became the focus of
interest. Naturally, for a considerable period of time a great deal
of emphasis was placed upon coronary anatomy. Simple relations
between narrowing lesions, impediment to flow, and prognosis were
assumed to exist. Spectacular results of surgical coronary
revascularization seemed to confirm this concept. Gradually it has
become evident that the pathophysiology of coronary artery disease
is considerably more complex. Diagnostic methods were introduced to
assess and quantify exercise-induced myocardial ischemia. At first,
these tests were used mainly to achieve a more discriminative
selection of candidates for coronary arteriography and the coronary
arteriogram remained the gold standard. Currently, these techniques
have evolved to the point where they provide valuable functional
and metabolic information. They have become powerful independent
tools in clinical investigations and evaluation of individual
patients.
General
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