Depending on the acuity and severity of symptoms, angiography or evaluation for ischemia with noninvasive testing is warranted. An additional, but less quantifiable, benefit of coronary angiography and LV function assessment derives from the ability of experienced angiographers to integrate the findings on coronary angiography and left ventriculography to estimate the potential benefit of revascularization strategies discussed below. The characteristics of coronary lesions (eg, stenosis severity, length, complexity, and presence of thrombus), the number of lesions posing jeopardy to regions of contracting myocardium, the possible role of collaterals, and the mass of jeopardized viable myocardium also can afford some insight into the conse- quences of subsequent vessel occlusion. For example, a patient with a noncontracting inferior or lateral wall and severe proxi- mal stenosis of a very large LAD artery is presumably at substantial risk of developing cardiogenic shock if the LAD artery were to become occluded. In view of the importance of proximal versus distal coronary stenoses, a jeopardy score has been developed, which takes the prognostic significance of a lesion s location into consider- ation.378 Angiographic studies indicate that a direct correlation also exists between the angiographic severity of CAD and the amount of angiographically insignificant plaque buildup else- where in the coronary tree. These studies suggest that the higher mortality rate of patients with multivessel disease could occur because they have more mildly stenotic or nonstenotic plaques that are potential sites for acute coronary events than do patients For many years, it has been known that patients with severe stenosis of the left main coronary artery have a poor progno- sis when treated medically. 