Report of the ad hoc committee on the indications for coronary arteriography. Prepared by the council on clinical cardiology of the American Heart Association.

The purpose of this report is to aid physicians as they consider performances of coronary arteriography in individual patients. The recommendations are largely based on published reports about the procedure, coronary disease and current approaches to treatment. The fact that relevant information is accumulation rapidly has been taken into account and it is hoped that the guidelines will be adaptable in this time of change. However, the results of clinical trials of coronary bypass surgery now in progress could necessitate a revised point of view in the future. A guiding principle in preparation of this document was that the findings from arteriography should resolve diagnositic problems, or serve to evaluate patients for treatment which has known therapeutic outcomes. These goals should be readily apparent. An example is arteriography to evaluate the feasibility for coronary surgery for intractable angina pectoris. In a few areas, arteriography as preparation for coronary bypass surgery is suggested as a promising plan to deal with desperate illness, despite incomplete information about outcomes. The role of coronary arteriography is explored in various clinical syndromes which include chest pain of uncertain origin, chronic stable angina pectoris, main left coronary artery disease, unstable angina, latent coronary disease, after recovery from myocardial infarction, recurrent ventricular arrhythmias, the problem of sudden death, after aorto-coronary bypass surgery and acute myocardial infarction. Alternative opinions are mentioned in various sections of the report, but whenever possible, a concensus of the committee's opinion is given.