What does this angiography report results indicate?
Patient: My history is: Antoroseptal MI on 14.02.11, thrombolysed with STK. Angiography (24.02.11) results: LMCA-Nor.; LAD-40% Ostial Segment Stenosis & 90% mid Segment Stenosis; D2-80% Ostial Segment Stenosis; LCx- 30% mid Segment Stenosis. PDA-RCA   Ostial Segment Stenosis. Coronary Angioplasty Report (24.02.11): PTCA / Stent (XIENCE Vascular) to LAD + Inj. Faximab with good end results & no residue stenosis or flap.Discharge Summary (26.02.11): Acute Anterior Wall Myocardial Infraction, Double Vessel Disease, PTCA + Stent to LAD, LV Dysfunction (LVFE 45%).Stress Echo (16.06.11) Report: LVFE 50% at rest & 60% at Impost. Trace MR at rest & No MR at Impost. Impression: Negative for reversible Myocardial Ischaemia.Myocardial Perfusion Scintigraphy Report (19.01.12): Test done following i/v Inj. of 110 MBq of TI201 at rest & 444 MBq of Tc99m Tetrofosmin at Bruce. Exercised for 06.51 Min. & attained heart rate of 148 BPM (89% MPHR). Test Reveals: Post stress images show reduced tracer uptake in septal / anteroseptal & apical wall of LV myocardium. Refilling kinetics is seen in above mentioned area at rest thallium images.Impression: Features of SPECT myocardial perfusion scintigrapghic study are showing evidence of exercise induced reversible ischaemia in Septal / anteroseptal and apical wall of LV myocardium.Personal observations: Post angioplasty I used to have throat irritation on exertion. Even during stress echo on 16.06.11 & on 19.01.12  the throat irritation / chocking feeling increased  & exercise had to be stooped.Now what do you conclude & suggest future course of action.I shall be highly obliged for your expert consultations / suggestions. Thanking You & RegardsAnil Goel+91 0000 YYYY@YYYY ;  YYYY@YYYY Doctor: Dear Anil Goer,On your angiography in 2011, there were  significant narrowing of two coronary arteries and some non significant marrowings which couldn't cause any ischemia and complaints. One significant marrowing was treated with stent, but the other one remained. I think they didn't perform stenting of the other artery as the stress test results were good in 2011, but of you have positive stress test results in a year, then there is a need to repeat coronary angiography to evaluate arteries again, there may be two possibilities, either the other narrowings became more and are significant now or it is the D2 from the first angiography causing the problems. In both cases angioplasty (stenting) may be needed.Take careCome back if you have any further questions