Conversation: The conversation between human and AI assistant.
[|Human|] today ekg showed anterior/lateral ischemia. 6 mos ago normal, my pcp told me he read my strfess test from 6 mos ago, and thinks I should talk to a cardiologists about a heart cath...i m74 M; end stage renal disease ready for dialysis should I rush into a heart cath with contrast?
[|AI|]  Dear Sir/ MadamThanks for your query.1. It is not absolutely mandatory to undergo angiogram to detect ischemia. There are other methods too. These include stress ECHO and Stress thallium tests (Nuclear MPI scan). If your stress tests come out to be positive, and you are really symptomatic, you need to get an angiogram done. However, the angiogram should only be done if you want to get the lesions (which will be diagnosed eventually) fixed by stenting or bypass. Second important this is that patients with kidney disease have 7 to 10 times higher risk of complications during angiogram/stenting/ bypass surgery. Your Cardiologist will also consider all these things to whom you must consult. Hope this provides some insight. SincerelySukhivnder