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  1. Those who already have suffered from a heart attack.
  2. Those who experience pain in the chest (angina) while performing routine activities of life.
  3. If the stress test (TMT ECG. Stress Echocardiography, Stress Myocardial Perfusion Imaging) is Positive. i.e., there is a strong suspicion about the presence of a serious defect in blood supply to the heart.
  4. Those who have serious reduction in efficiency of heart or a weak heart.

After examining the patient and reviewing his test reports if the cardiologist suspects a high probability of block in his coronary arteries, angiography is advised. Some patients are completely against angioplasty or bypass surgery because of their prefixed concepts or beliefs. In such cases angiography may not be performed, because angiography is not at all necessary for making choice of medicines. This can be meticulously done on the basis of symptoms and simple investigations like blood tests, stress test and echocardiogram.

In some cases angiography is done to risk stratify or ‘rule out’ serious coronary disease. As far as possible, use of angiography for this purpose is to be minimized. For such indications CT scan angiography is comparatively easier and more appropriate.