True patients* present with symptoms , please , don’t ever think all your patients bring their coronary artery for general servicing !
Ofcourse , we are the service provider to our patients . Though heart is a mechanical pump it can never be considered equivalent to automobile engine .
For a Heart service station equipped with 24/7 lab, the benefits may be more if you treat the angiogram rather than the patient.
Let us not misunderstand the word service , please show restraint, your patients will thank you forever.
* Silent significant CAD are indeed a problem in minority that requires selective wisdom.However, we can’t be aggressive hunters for CAD in population, as there is huge cost for human hunting !
Reference
Recent article which debates the issue of PCI in CTO
http://circ.ahajournals.org/content/135/15/1382?etoc=#sec-1
Dr.S.Venkatesan MD 
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