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Prof. José L. Zambrano, MD>>>: Jose L. Zamorano, MD: Cardiology is in a really continuous evolution.
Diagnostic methods in cardiology are really accurate, and we have noninvasive diagnostic
tools, and invasive diagnostic methods. Invasive implies, for example, coronary angiography,
and we need to puncture, and we need to just go with a catheter inside your vessels or
your arteries. Well, in noninvasive methods, I will focus my attention in that, and we
have started years ago, decades ago more than 50 years ago with ultrasound. Echocardiography
uses ultrasound, and is able to really diagnose what is going on with your muscle, with your
heart, is only able to analyze what is wrong with your cardiac valves, or is able to analyze
what is wrong with your pericardium or the aorta. But with echo, it is not possible to
analyze the coronary arteries. So with echocardiography, we can analyze the cardiac function but is
not possible to really see what is going on inside your coronary arteries. If I move forward,
then we have cardiac magnetic resonance. It is noninvasive, it is not using radiation,
it is quite accurate, and it provides the best tool for really accurate and detailed
information from the morphological aspects. Again the cardiac function, how is the muscle,
how is the heart and the cardiac valves. But again, it is not easy with cardiac MRI to
see the coronary arteries. There are some specific systems, machines, and protocols
and I will say not in many patients, it is possible to see the coronary arteries, but
it is not as a routine. More recently, years ago, but more recently, we have cardiac CT
scan. With cardiac CT scan, it is easier and, I will say it is again, quite accurate to
see the coronary arteries, and it is really a great method because for the first time
in a routine basis with a noninvasive approach, we do not need to puncture the artery. It
is possible to see the coronary arteries, and this is great, but you need to pay a price
for that, so CT scan is using radiation so is not really recommended to do in a continuous
way a CT scan periodically, but you can see the arteries. I think it should be -- it cannot
be a recommendation, a general recommendation when to do that, still we need some more detailed
guidelines from that, but on a patient-to-patient basis. You with your doctor need to really
analyze your specific case, and see what type of tests do you need, and what can be provided
with those tests.