CT angiogram or Direct Coronary angiogram?

[Tipsoo]

Update:

I changed my doctor to get a second opinion.  He is recommending angiogram.  Which is better in my case- CT angiogram or Direct Coronary angiogram?

This was my post before but no replies yet.

I'm 43, female with a family history of heart disease. I had chest discomfort a week ago after an emotional stress in the office ( like there was an elephant sitting on my chest!).  Was admitted in the hospital for further tests. My ECG was normal ( it has been normal during my confinement) Troponin I was .56, .098 then went down to .045.  They gave me aspirin, amlor, clexane injections and a nitro patch.  Echo doppler test showed some muscle not working so I underwent Dobutamin test.  They said result was normal.  I was discharged after 3 days and was given aspirin for 1 month. I was advised not to have any strenuous activity and just stay home for a few more days. Followup checkup today.  

My question is, did I have a heart attack? My doctor can't answer my question. I have occasional pains on my chest after discharge radiating to my right arm. ( sometimes on my left arm too)  I have upper back pains and shortness of breath even by just talking.  

Any inputs will be appreciated!  Thanks in advance.

[Tipsoo]

Hi,
I underwent CT angiogram yesterday in another hospital and got the results today.  My doctor is only available tomorrow.  I would appreciate if anyone in the forum can explain the results to me.  Thanks a lot!

LV Functional Analysis:

ED Volume is 139.4 cm3
ES Volume is 28.4 cm3
Stroke Volume is 111.1 cm3
Ejection fraction is 79.7%

Non-cardiac findings:
Left lung lower lobe atelectatic bands noted

Impression:
Coronary calcium score: ZERO
Dominant right coronary circulation
RCA (25-35%) stenosis at S2 due to soft wall plaque
No flow limiting lesions within the rest of the coronary arteries

Thanks in advance!

[Tipsoo]

Thank you very much for your reply.  We are still waiting for the approval of our insurance.  I will update you with the results. Thank you for time.  I really appreciate it.

[CCFCardio MD2]

I'm sorry to hear you're having some difficulty.  While you are young, 43 is certainly not out of the window of coronary disease.  Your story may just be an anxiety reaction, but given you had an elevated troponin, this signifies you had tissue damage to your heart.  This may have been a small heart attack or maybe a certain type of heart attack where your heart has narrowed vessels that then don't provide enough blood flow under conditions of stress.  CT angio is good if you have a very low suspicion for coronary disease and want to rule out significant blockages.  I would not say you are low risk for coronary disease given your story and troponin elevation.  I would recommend a cardiac catheterization to look at and possibly fix your coronary vessels, but please discuss this with your cardiologist who knows your history better than I do.

Best of luck.