Coronary angiographyis generally regarded as the "Gold Standard" for diagnosing coronary artery disease. If a patient has chest pain and the angiogram is said to be "negative," most of the time that chest pain is non-cardiac in origin. ( Here is a review of chest pain and its causes, both cardiac and non-cardiac.)
However, in at least three conditions, coronary angiography can look "normal" in patients who actually have true coronary artery disease. All three of these conditions are especially likely in women, though it is possible to see them in men. And all three of these conditions have features that ought to alert the doctor (and the patient) that the symptoms are cardiac in nature, despite the ostensibly "normal" angiograms - and should lead to further evaluation and ultimately to appropriate therapy. Click on the links to read more detail on these three conditions:
- Prinzmetal's Angina- severe spasm of the coronary arteries
- Cardiac Syndrome X (CSX)- a condition involving the small, invisible (invisible, that is, on coronary angiography) coronary arteries
- Female-pattern CAD. - a pattern of true atherosclerotic coronary artery disease seen mainly in women
