Value of nuclear medical procedures in coronary heart disease

The role of nuclear cardiology procedures in patients with suspected or known coronary artery disease lies in between clinical examination and left heart catheterization if diagnosis, prognosis or treatment effects are to be assessed. In other situations, these tests add important information to coronary angiography regarding functional significance of coronary artery stenoses and viability of involved myocardium. Based on results of several studies, patient groups can be identified in whom no further investigations are necessary after scintigraphic testing, whereas in other patients, non-invasive diagnostic testing may be omitted because coronary angiography is mandatory based on clinical findings. According to such considerations, diagnostic approaches to patients with coronary artery disease with and without previous myocardial infarction are proposed in this paper taking into account clinical assessment as well as non-invasive and invasive testing. (orig.)