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Coronary angiography is considered to be the gold standard technique for assessing the severity of obstructive luminal narrowing; however, in a few circumstances it may be misleading. In these cases, cardiac computed tomography (CT) and intravascular ultrasound (IVUS) may help to give a correct interpretation.  In this report, we describe the case of a 62-year-old man whose effort angina was first evaluated with coronary angiography, but whose severe stenosis of the right coronary artery was only observed on cardiac CT and IVUS. This additional diagnosis promptly resulted in a therapeutic approach with percutaneous transluminal coronary angioplasty (PTCA).

Effort angina in a patient with advanced coronary artery disease. Role played by coronary angiography, Ivus and cardiac CT: case report