[Yes, routine coronary angiography is necessary after myocardial infarction]

The author first recalls the difficulties and inaccuracies of the exercise test, even when this is combined with an isotope test in post-infarction evaluation of the myocardium. In most cases, a coronography should be performed after about ten days (because most deaths following myocardial infarction occur either within the first three weeks or within the first three months). The risks are minimal. This exploration provides a more detailed assessment of the lesions as well as detecting severe latent lesions affecting other coronary circuits. In some cases, it assists in diagnosis and may even be a guide to treatment. However, it is not easy to evaluate stenoses, and one of the big drawbacks of the method is that it is not always possible to draw all the necessary conclusions regarding the therapeutic consequences of revascularization. Coronarography is indispensable after infarction in most subjects, but it must be evaluated with caution and must be combined with an exercise test, even though the information provided by this test is only incomplete.