Is coronary angiography needed for minor arterial blockage?

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Your reports are overall fine (attachment removed to protect patient identity) with some age-related and nonsignificant changes. ECG (electrocardiography) is fine, and echo shows some minor leakages, which are fine to have in this age group. So no significant abnormalities. TMT (treadmill test) is also normal, and Doppler shows some changes, but again not significant. Normal TMT means there are no significant or severe blockages, but minor blockages (as seen on arterial lower limb doppler) might be there in heart arteries. So one should be on low dose medications to prevent worsening. So, in a nutshell, no significant abnormalities on the available cardiac test. I hope this helps.

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No, CT coronary angiography is not routinely indicated if TMT is negative. However, TMT cannot rule out the possibility of minor blockages, which CT coronary angiography can rule out. Such minor blockages require medication. So if risk factors like hypertension, dyslipidemia, family history of heart disease are there or even otherwise as preventive measures in elders, one should be on Aspirin and statin, if not contraindicated.