â?¢     I needed an opinion on the relative merits / preference of an angiograph vs a Stress MPI â?¢     This is actually for my mother. She has been through an Echo and a TMT and 2 different doctors have advised the 2 different tests â?¢     She has had diabetes for 17 years, has hypertension and asthma - she was to go through a hernia operation and as part of the pre-op checks the cardiologist picked up something in the echo and tmt tests â?¢     The TMT tests read - Moderate Effort Tolerance, Normal HR and BP response, Baseline ECG Shows DT Depression, Horizontal ST Segment depression noted in early recovery, no Angina / Arrhythmias **** TMT positive for Inducible ischemia*** On the Echo the impression reads are: Concentric LVH / Trivial MR / Trivial AR / Trivial TR , Mild PAH / LV daistolic dysfunction Grade II / Normal LV systolic function (I could get the reports scanned and sent through to you if that would be preferable) â?¢     The impression I was given by the 1st doctor recommending the angiography was that the stress MPI is not conclusive and definitive and the only way to get a clear picture would be angiography. Whereas the other doctor preferred a sequential approach of doing the Stress MPI first. â?¢     I wanted an opinion on the preferred route forward.