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If the 2D echo test report is normal, is there a need to do angiography?
Answer can be yes or no. If one has chest pain or any other symptoms suggestive of blockages in heart vessels, one needs to undergo angiography even if a 2d echo test is normal. Changes in the 2d echo test occasionally occur a few years later after the development of CAD. If there are no symptoms suggestive of CAD and the patient has no risk factors, ECG test is normal, and treadmill test is normal, he may not need any angiography.
A special type of 2d echo called stress echo where echo is done during exercise or while giving a medication that simulates exercise is most useful for identifying CAD over a simple 2d echo test. Even a simple treadmill test is more useful than a simple 2d echo test for finding blockages in coronary arteries. (CAD).
2D echo test can not arteries of the heart because it is beyond its resolution. However, in a heart attack (myocardial infarction), RWMA develops in the heart which can be in 2d echo. But angiogram is not done only in heart attacks, it has other indications also. Chronic stable angina is the most common indication among all for heart angiogram . in chronic stable angina, a 2d echo test is often normal. In such kinds of people, an angiogram is done even when 2d echo is normal. CT angiogram is an alternative for such patients.
2d echo is normal but clinical probability of CAD is very high
Your heart specialist may advice a stress (treadmill test. stress echo test or nuclear echo test) test or angiogram (CT angiogram or conventional coronary angiogram).
2d echo is normal and clinical probability of CAD is low
Your cardiologist may not ask you to get any stress test or angiogram test.
2d echo is abnormal and clinical probability of CAD is very high
Your doctor will straight away advices you coronary angiogram.