The dynamic nature of the coronary vasculature and its stenoses frequently requires more than a subjective anatomic visualization to evaluate potential myocardial ischemia. Although coronary arteriography can assess stenoses of no hemodynamic importance (less than 20 per cent diameter reduction) and lesions that severely impair blood flow (greater than 80 per cent diameter reduction). Most coronary stenoses fall between these two extremes. Quantitative arteriography and radioisotope perfusion studies can improve the accuracy of predicting myocardial ischemia.