Nearly 50% of heart attacks occur in non obstructive coronary plaques - a phenomenon called plaque rupture.
Unfortunately tests like ecg, echo( rest tests) or stress tests ( TMT) have very poor sensitivity to identify such “Vulnerable plaques”
TMT typically picks up only significant narrowing like more than 80 % stenosis ( even in them it can miss out30% times)
Hence an individual’s overall risk needs to beunderstood based on other markers like lipid profile , Hba1c inflammatory markers, significant family history , smoking status and in indicated patients CT ( CT ca score/ CT CA)
So what to do ? CT Angiography. Please answer for the benefit of X users