Coronary CTA is a method of imaging the coronary arteries of the heart by injecting contrast into a peripheral vein (median elbow vein), scanning it with spiral CT, and finally processing and reconstructing it with a computer. Coronary angiography is performed by inserting a tube through an artery (such as the radial or femoral artery) to the opening of the coronary artery, injecting contrast directly into the coronary artery, and then taking an x-ray to obtain coronary artery imaging. The advantages of coronary angiography Coronary angiography is still the “gold standard” for the diagnosis of coronary artery disease, and it can evaluate the location and degree of coronary stenosis, and if necessary, interventional treatment (such as balloon dilation or stenting). Disadvantages of coronary angiography 1. Invasive operation: Although minimally invasive. 2. More risky: it is an invasive operation with greater risk and more possible complications (such as hematoma, infection, perforation, entrapment, etc.). 3.Higher cost: compared with coronary CTA, the cost is higher (about 5000 RMB). 4. Postoperative bed rest is usually required, and the radial artery route is shorter. Advantages of coronary CTA Non-invasive examination, relatively simple, low risk, relatively low cost (about 2000 RMB), patients can complete the examination in an outpatient clinic, and its negative predictive value is high, which means that if no abnormality of coronary artery is found in coronary CTA, coronary artery stenosis lesion can be basically excluded. Disadvantages of coronary CTA 1. Large amount of contrast agent. Compared with coronary angiography, the applied contrast agent dose is larger. For patients with impaired renal function or the elderly, this effect will be more obvious and special attention should be paid. 2.The degree of accuracy is slightly worse. The patient’s heart rate and whistling motion during the examination can affect the results of coronary CTA. The determination of the degree of coronary stenosis by coronary CTA may be more inaccurate. 3.The diagnosis of specific lesions is limited. When there is calcified plaque in the coronary arteries and coronary stenosis is suspected, it must be changed to coronary angiography for evaluation. That is, coronary CTA is only a diagnostic tool and cannot be performed for treatment. Generally speaking, for patients with high suspicion of severe coronary stenosis (such as frequent angina attacks), combined with high-risk factors for coronary heart disease (such as dyslipidemia, diabetes, hypertension, smoking, etc.), or acute myocardial infarction, coronary angiography is performed directly and interventional treatment is performed when necessary. For patients with atypical clinical symptoms who need screening to exclude coronary artery disease, coronary CTA is recommended. The specific needs to be judged by clinicians.