 He required 3 sublingual nitroglycerin in total (please see also admission history and physical for full details).,The patient underwent cardiac catheterization with myself today which showed mild-to-moderate left main distal disease of 30%, moderate proximal LAD with a severe mid-LAD lesion of 99%, and a mid-left circumflex lesion of 80% with normal LV function and some mild luminal irregularities in the right coronary artery with some moderate stenosis seen in the mid to distal right PDA.,I discussed these results with the patient, and he had been relating to me that he was having rest anginal symptoms, as well as nocturnal anginal symptoms, and especially given the severity of the mid left anterior descending lesion, with a markedly abnormal stress test, I felt he was best suited for transfer for PCI. 
He required 3 sublingual nitroglycerin in total ( please see also admission history and physical for full details).,The patient underwent cardiac catheterization with myself today which showed mild - to - moderate left main distal disease of 30 % , moderate proximal LAD with a severe mid - LAD lesion of 99 % , and a mid - left circumflex lesion of 80 % with normal LV function and some mild luminal irregularities in the right coronary artery with some moderate stenosis seen in the mid to distal right PDA.,I discussed these results with the patient , and he had been relating to me that he was having rest anginal symptoms , as well as nocturnal anginal symptoms , and especially given the severity of the mid left anterior descending lesion , with a markedly abnormal stress test , I felt he was best suited for transfer for PCI .