# When Intracoronary Anatomy is Superior to Physiology

## TL;DR

This paper explains when coronary anatomy provides better insights than physiological measurements for assessing heart disease severity.

## Contribution

The paper highlights specific clinical scenarios where anatomical assessment is more reliable than physiological methods.

## Key findings

- Anatomy is more accurate than physiology in acute coronary syndromes and left main disease.
- Physiological measurements may be misleading in saphenous vein graft lesions and myocardial bridging.
- The paper suggests ways to address the limitations of physiological assessments in these cases.

## Abstract

Physiologic assessment has become an essential tool to guide revascularization
decisions due to the multiple limitations of angiographic and anatomic measures
of physiologic significance. However, in certain cases the apparent physiologic
measurement may not accurately reflect the severity of coronary disease compared
with anatomical measurements. This article will review how anatomy trumps
physiology in cases of acute coronary syndromes, left main disease, saphenous
vein graft lesions, and myocardial bridging, and how to overcome the limitations
of physiologic measurement in these clinical situations.