Multimedia
 | Media file 1: Selective injection image of the left coronary arteries. D1 = first diagonal, LAD = left anterior descending artery, LCX = left circumflex, LM = left main coronary artery, and OM1= first obtuse marginal. |
 | Media file 2: MRIs of the coronaries can be used to build 4-dimensional images (3-dimensional beating heart). These images show a single frame, including a cutaway view to show the cardiac interior, the outer surface (no thresholding), and the extracted coronary artery tree including the aortic root. |
 | Media file 3: Elastic-match imaging automatically identifies differences between image volumes. The acquisition of 1 set of contrast-enhanced chest CT images via the coronaries and a nonenhanced set provides a 3-dimensional view of the coronary-artery tree. The nonenhanced volume data were rendered as holographic projections to provide the anatomic context, and the elastic-match coronary tree was overlaid. In addition to automation, this method avoids thresholding so that small branches and filling defects, if present, are represented properly. |
 | Media file 4: Elastic-match imaging can be used to identify collateral-dependent myocardium. Left and middle images are baseline and peak-arrival collateral-sensitive MRIs demarcating microvascular development. Right image, based on CT imaging of the heart, was obtained with and without back pressure to nullify collateral-dependent perfusion; white volume on represents collateral-dependent myocardium. The extent of collateral-dependent myocardium corresponds well on MRI and CT (r = 0.95). |
 | Media file 5: Contrast-labeled blood to the heart is used to identify the territory at risk. The results of this assessment of the delayed arrival compares favorably to the findings of radionuclide stress imaging, and stress induction of ischemia is not required to identify the zone at risk. |
 | Media file 6: Space-time maps show the history of blood arrival to all layers of myocardium on a 2-dimensional map. The indentation indicates the severity of the defect in blood delivery, and the length indicates the size as a percentage of the myocardium, without the need for stress induction of ischemia. In addition to the safety advantage, this method is also more reproducible than stress testing, which is useful in assessing the effect of therapy. |
 | Media file 7: Compared with radionuclide images of blood delivery, MRIs and CT scans improve resolution, depiction of the functional effect and the relationship to the coronary supply, and identification of the area at risk without stress. The advantage of radionuclide imaging is primarily its predictive value; stress echocardiography has similar predictive value. MRI and CT have been less available than other studies; therefore, data on their value are relatively limited. |
 | Media file 8: X-ray angiography is the criterion standard for delineating the coronary anatomy, but it is inferior to MRI and CT in identifying myocardium with impaired blood delivery, in assessing the functional consequences, and in identifying the development of microvascular collaterals. |
More on Coronary Artery Disease |
| Overview: Coronary Artery Disease |
| Imaging: Coronary Artery Disease |
| Follow-up: Coronary Artery Disease |
 Multimedia: Coronary Artery Disease |
| References |
| Further Reading |
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Further Reading
Related eMedicine topics
Coronary Artery Calcification - CT
Coronary Artery Atherosclerosis
Primary and Secondary Prevention of Coronary Artery Disease
Risk Factors for Coronary Artery Disease
Comparison of Revascularization Procedures in Coronary Artery Disease
Clinical guidelines
The Primary and Secondary Prevention of Coronary Artery Disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)
Drug-Eluting Stents for the Treatment of Coronary Artery Disease
Clinical studies
Influenza Vaccination in Prevention From Acute Coronary Events in Coronary Artery Disease - FLUCAD Study
Exercise Training, Insulin Resistance and Coronary Artery Disease
Keywords
coronary artery disease, CAD, heart disease, coronary angiography, coronary angioscopy, coronary artery imaging, magnetic resonance angiography, MRA, stress test, perfusion imaging, collateral-sensitive imaging, heart attack, myocardial infarction, MI, acute myocardial infarction, AMI, angina, UA, unstable angina, stent, DES, drug-eluting stent
