Hello Remya and thanks for writing in at HCM I am jr. to a cardiologist in India and read your mail in detail. You have described that their are some changes in ECG and had undergone Treadmill test. As your father is Hypertensive and diabetic and if his TMT is positive for Inducible Ischemia than there is strong indication of Coronary Angiography to rule out Coronary Heart disease . Other risk factor for Coronary Heart disease are: 1. Family History 2. Increasing age 3. Being a male, we cant do any thing for these 3 factors 4. Heart disease like Hypertension 5. Diabetes 6. High Cholesterol and triglycerides 7. Low good Cholesterol (HDL) 8. Smoking Calculate the risk factor you have present. Now there is question of Coronary angioplasty. There is fifty fifty chance of it. If the block or lesions in the artery are small than it may be treated by medication and life style changes only but you have to take lot of precautions. If lesions is such kind that it may cause Heart attack in future than angioplasty is required. It is better to do angioplasty immediately after angiography because patient feels comfortable and pain will not be caused again and again for inserting the cannula for angiography and angioplasty. Same cannula are used for both the procedures. Coming to your last query, there is no alternative of this. If you has Ischemic ECG changes, TMT positive, Chest pain (may be absent in diabetic patient), Chest discomfort and shortness of breath on exertion than you have to go for the above said procedure. My last advice to you is that go for angiography and than for angioplasty if needed and advised by your cardiologist. Best Wishes Dr. Dinesh Kumar Bhatia Health Care Magic