There are more patients with renal insufficiency combined with coronary heart disease, and often patients or doctors ask whether they can have cardiac imaging. We all know that after the angiogram may occur contrast kidney damage or cholesterol crystals dislodged causing blockage of small renal arteries, which may lead to deterioration of renal function. My advice is to decide whether to do a cardiac angiogram based on the opinion of the cardiologist. If their opinion is that it can be done or not done, it will be withheld or not done; if their opinion is that it should be done, it must be done.