Conversation: The conversation between human and AI assistant.
[|Human|] Hi Respected doctor, My sister in law is 62 years and general medical specialist referred her to cardiologist for stress thalliumtest/debulleaine plus minusCA-RP. She is diabetic for the last 22 years. We consulted the cardiologist who after seeing the history and on going treatment first conducted TMT and then advised and carried out angiography, Angiography report is as underHTN, DMII, CA-DOE, TMT moderately positive(21/03/11) and CAG-Triple VesselDisease(22,03.11)Past History k/c/o DMII 22 yrs on reglar Medicine ,HTN since 20 yrs on regular medicineNo H.o RHD/BA.TB/ other chronicillnessangio graphy report as  followsLmca  normalLAD MID AND DISTA lad-SEVERE CALCIFICATION,LONG TUBULAR 70 PERCENT Stenosis   Ds normalLCX    Co Dominent VesselOMs-OMI-Diffused DiseasedRCA Dominent Vessel- Mid RCA 75 percent stenosis    PLV/PDA-NormalLV ANGIO NOT DONEFINAL DIAGNOSES  CAD, Triple Vessel Disease                             DMII,TMT POSITIVE (MODERATELY)RECOMMENDATION   Stress Thallium for Inducible Ischemia.Now  we are advised to go in for Thallium Test. Kindly advise whether Thallium test only as recommended by medical specialist should have been carried out before  Angiography or the cardiologist has used his discretion as we are laymen and did not know about thallium test . If thallium test was not available in cardiologists clinic/hospital  why he did not refer us to another hospital where Nuclear Science test facility for Thallium test was available. ALso we shall be grateful  for the correct advice at this stage to safeguard the interest of the patient ,.REGARDS
[|AI|]  After having gone through the reports and the finding of triple vessel disease on coronary angiography, i don't think stress thallium would achieve anything much as far as diagnosis is concerned.  It has probably been advised because TMT has come put to be moderately positive instead of being strongly positive which would be expected with the angiography findings. She mostly needs a coronary area by pass surgery (CABG).