5 Interpretation of Findings

The focus of the study varies depending on the underlying cardiac disease or on the intervention being performed. The details will be discussed in the chapters on the specific disease entities.

Independently of the underlying disease the following basic rules and frequent pitfalls should be considered when interpreting the findings.

1. Before finishing the examination the completeness and conclusiveness of the angiographic and hemodynamic findings should be checked:

– Are invasive findings and noninvasive findings congruent?

– Is the severity of valvular disease as assessed by catheterization and by echocardiography comparable? (Have the potential sources of errors of both methodologies been considered?)

– If no coronary stenoses have been visualized despite typical symptoms and positive stress test: have all sources of error been considered (eccentric stenoses, foreshortening, coronary anomalies, etc.)?

– In the case of CAD: Do findings on the coronary angiogram correspond to ventricular function? Have all coronary arteries been visualized (atypical course with coronary anomalies)?

– If systolic ventricular function is good but there is a history of heart failure: is there evidence for diastolic dysfunction?

– With increased oxygen saturation in the pulmonary artery: are shunt detection and measurement required?

– Are the findings sufficient for patient management?

– For a planned valve replacement, the proper functioning of all valves should generally be known.

– Have epicardial collateral vessels been sufficiently visualized before a planned coronary artery bypass graft procedure (CABG)?

– Before a planned CABG: is preoperative angiography of the internal mammary artery helpful to the surgeon?

– In severe heart failure: were the coronary veins sufficiently visualized for CRT?

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