What tests should I do if I suspect I have coronary artery disease? If it is diagnosed, is it better to put stents in internal medicine or to do bypass surgery in surgery? If you suspect that you have coronary artery disease, you should not just take any medication. You should go to a regular professional hospital with a specialized department (cardiology), and your doctor will prescribe an electrocardiogram, cardiac ultrasound, exercise stress test, nuclear examination, cardiac CT and coronary angiography. It is important to emphasize that only coronary angiography is the gold standard for diagnosis, and it is up to the cardiologist to make a judgment on whether or not it is needed based on your condition. If the diagnosis is clear after coronary angiography, there are five cases as follows: First, there is indeed coronary artery disease, but the degree is not serious and does not require medical stenting or surgical bypass surgery, but only oral medication with diet adjustment and appropriate exercise. Second, the extent of the lesion is so great that it cannot be solved by medication alone and requires and is suitable for medical treatment by stenting. Third, the extent of the lesion is such that it is not suitable for stenting, and surgical bypass surgery is required. Fourth, the extent of the lesion is suitable for medical-surgical collaboration, surgical minimally invasive to build a major arterial bridge with a high long-term rate, and medical doctors in other lesion vessels to put in stents, together to complete the treatment, we call it hybrid surgery. Fifth, the extent and scope of the lesion and other combined conditions make it impossible to put in stents and surgical bypasses, and the only way to maintain it is to take medication. There is another special case, for example: if a patient has an acute inferior wall myocardial infarction, and the right coronary (i.e. the infarct vessel) is found to be directly stented by the internal medicine doctor, but other vessels are not suitable for stenting, the internal medicine doctor will consider saving the ischemic damaged inferior wall myocardium as soon as possible and put a stent in the right coronary to ensure patient safety first. The anterior descending branch, which is not suitable for stenting, will be bypassed by later surgical bypass. In fact, this is also a reasonable treatment mode inside the hybrid surgery, why mention it separately here? In our clinical work, we found that most patients do not know enough about this treatment modality and do not understand it, saying, “Why should I put in a stent if it cannot solve all the problems? I have to suffer twice, it would be better to have a direct bypass!” Here we explain it together. As for the patient’s main concern, if the coronary angiography examination clearly shows the severity of the lesion, which is better, stenting, bypass surgery or hybridization? How to choose? This is a professional question, and the specific choice needs to be considered by the doctor according to the lesion and other factors such as the patient’s physical condition. It varies from person to person and no specific answer can be given. Even we doctors choose the most beneficial method for our patients according to the constantly updated guidelines. Our general principle is that, while coronary angiography is done in the internal medicine department, the internal medicine doctor will determine whether it is suitable for stent placement, and if so, the stent will be placed. If it is not suitable, only then will we consider a surgical consultation to see if bypass surgery is appropriate. There are a small number of patients that are suitable for bypass surgery. In conclusion, our advice on this issue is that the patient and family should fully trust the doctor and recognize and respect the doctor’s treatment plan. Only with mutual trust can the best treatment results be achieved.