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Young male w/ palpitations and low left ejection fraction -- angiogram ...
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Young male w/ palpitations and low left ejection fraction -- angiogram for sure?

Seeking advice for a good friend. In the past few weeks he felt his heart was skipping beats, then beating faster than normal right after. Otherwise he's very healthy and young (30s). The cardiologist said this is fairly common and probably nothing to worry about, confirmed with a holter monitor (tachycardic beats but nothing super concerning). Just to be sure, he ordered a cardiac ultrasound (not a stress test). The results indicated a low left ejection fraction (~45%). The nurse simply said "when would you like to schedule your angiogram (angioplasty if necessary)"! As if this were a simple strep test, no big deal! This is an invasive procedure, is there any other less invasive way to get the same information (CT angiogram?)? Any surgery has risks. The doctor even said he was very surprised at the ultrasound result, as he originally thought there would be nothing unusual. Would someone young and thin really have CAD? Or is this something that lots of people probably have... maybe if you tested 10 people, some of them would have low ejection fraction... but most people just don't check and have no problems? The nurse seemed shocked that he didn't just schedule this thing immediately, but what if the ultrasound is just a strange result? He has no other symptoms (pain, breathing, etc.). Any advice would be appreciated. He'll also  contact the doctor to discuss options directly of course.
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