Imaging coroanry artery is generally in the domain of interventional cardiologists. MDCT has helped us to change that.
The humble echocardiography can identify the origin* of coronary arteries in most persons. The resolution power of modern day echocardiography is 2mm and the left main ostium is >3.5mm in 99% of population . If some body says one can’t visualise the coronary artery by echo , it can only reflect their ignorance or lack of patience to get an optimal image. Of course technological limitations are there.
* To be emphasised again , only the origin can be identified.
Can we identify ostial leftmain or proximal left main disease by echocardiography ?
It should be possible in few .
Can we place a doppler sample volume within the left main and measure coronary flow velocity ?
When obsterticians are able to assess the uterine artery flow in a bulky uterus , it should be possible to do the same in a coronary artery . Motion artifacts is the issue in the heart. Micro sample voulme (<1mm) are expected in the future that will make a non invasive coronary flow assesment a distinct possibility.
Dr.S.Venkatesan MD 