Imaging of the left ventricle in patients with ischemic heart disease: role of the contrast angiogram.

The contrast left ventriculogram is the gold standard against which all other cardiac imaging techniques are measured. In the past decade, noninvasive methods such as radionuclide angiography, echocardiography, computed tomography (CT), and digital substraction imaging have become available. This review examines the role of these techniques, and whether they will supersede the selective contrast ventriculogram. Each of these modalities seems to have specific capabilities and superiority in a certain area. Contrast ventriculography is best suited for the functional assessment of the left ventricular wall. Isotopes and CT have great potential for evaluating the myocardium properly. Echocardiography produces good visualization of atrioventricular valves and intracavitary structures. The role of contrast angiography is considered in the workup of the cardiac patient. The contrast angiogram is closely related to the coronary angiogram in the assessment of the patient with arteriosclerotic heart disease and it is still a necessity for the preoperative evaluation of the patient with congenital heart disease.