Background- There are few studies which compared invasive coronary angiography (CAG) in patients presenting with chest pain (atypical, probably ischemic) in outpatient department with negative or inconclusive treadmill stress test (TMT). Objective- To assess CAG findings in patient with suspected iscemic chest pain, with negative or inconclusive TMT. Methods- Patients with chest pain (atypical, probably ischemic) underwent TMT and classified as TMT negative or inconclusive. These patients underwent CAG and findings were analysed. Results - 50 patients completed the study protocol. Of these 50 patients who underwent TMT, 31 (62%) were TMT negative and 19 (38%) were TMT inconclusive. In TMT negative group CAG showed obstructive lesion in 6(19.4%), and non obstructive lesion in 25(80.6%). In TMT inconclusive group CAG showed obstructive lesion in 11(57.8%), while non obstructive lesion in 8(42.2%). Conclusion-In patients with atypical chest pain with negative or inconclusive TMT with suspicion of coronary ischemia CAG provides an important diagnostic tool for assessing, especially with TMT inconclusive group.

Background: There are few studies that compared CTCA in patients presenting with chest pain, probably ischaemic (i.e., atypical) with negative or inconclusive TMT in outpatient department. Objective: To assess 64-slice CTCA findings in patients with suspected ischaemic chest pain and negative or inconclusive TMT. Methodology: Enrolled patients underwent TMT and classified as TMT negative or inconclusive patients. These patients underwent CTCA and findings were analysed. Results: 50 patients completed the study protocol. Of these, 31 (62%) were TMT negative and 19 (38%) were TMT inconclusive. CTCA showed obstructive CAD in 19 (38%) patients; 7 (36%) with negative TMT and 12 (63%) with inconclusive TMT. Overall, CTCA was more predictive of diagnosing obstructive lesion in TMT inconclusive group as compared to TMT negative group. Conclusion: In patients with atypical chest pain with negative or non-diagnostic TMT, CTCA provides an important diagnostic tool for rapid triaging of such patients.