What is the gold standard for diagnosing coronary artery disease?

Coronary angiography is considered the gold standard for diagnosing coronary artery disease (CAD) due to its ability to visualize the coronary arteries directly. This invasive procedure involves injecting a contrast dye into the coronary arteries and taking X-ray images to assess blood flow and identify blockages or narrowing in the arteries. It provides detailed anatomical information that is crucial for determining the presence and severity of CAD, which can be used to guide treatment decisions, including the possibility of surgical interventions such as angioplasty or bypass surgery.

While other diagnostic methods like exercise stress testing, radionuclide imaging, and CT scans are valuable tools in evaluating cardiovascular health and assessing patients for CAD, they do not provide the same level of detail and precision as coronary angiography. Exercise stress testing evaluates functional capacity and may suggest the presence of CAD, but it is less definitive. Radionuclide imaging can assess myocardial perfusion but also does not provide direct visualization of the coronary arteries. CT scans can be useful for non-invasive evaluation of coronary anatomy and assessing for coronary artery disease, but it is not the established gold standard like coronary angiography.