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Coronary angiogram is still considered the gold standard imaging modality to study the anatomy of coronary arteries. It assesses two dimensional anatomy of coronary arteries which is one of its inherent limitations. Utility of sound waves in intravascular ultrasonogram (IVUS) and infra red waves in optical cohenece topography (OCT) have allowed interventional cardiologists to assess and interpret the coronary anatomy better especially if the angiogram is equivocal. Optical coherence topography, with its excellent spatial and temporal resolution, provides images of exceptional qualities to identify the characteristics of plaque and to assess the results of interventions. A 56 year old male presented to us with recent worsening of exertional angina. He was diagnosed to have non ST elevation myocardial infarction (NSTEMI) 5 years ago. He underwent angiogram elsewhere, and was diagnosed to have spontaneous coronary artery dissection in left anterior descending artery (LAD). He was started on maximal medical therapy. He was doing fine till 3 months ago, when he started having exertional angina for which an exercise stress test was done which was found to be positive for stress induced ischemia at moderate workload. An Angiogram was repeated. It revealed significant left anterior descending artery (LAD) disease astride first septal and diagonal artery with translucencies across the entire segment of lesion (Fig. 1 and Videos 1 and 2 in Supplementary materials) along with mild disease in left circumflex and right coronary arteries. It also

Utility of OCT In a patient with chronic stable angina— “All that is seen using dye is not true”