### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
My mother has cardiac problems. Her Angiogram report says " LAD -Type III, good size vessel having 40-50% stenosis at its proximal & 70-80% stenosis at its mid segment. D1 has got 95% stenosis at its proximal segment. D2 has got 30% stenosis at its proximal segment.LCX: Dominant, good size vessel having 95-98% stenosis at its mid segment.RCA: Non dominant vessel having 60-70% stenosis at its proximal segment. What does it mean?

### output:

Hello. Thank you for your question and welcome to Chat Doctor. I understand your concern. This angiogram report indicates that this is a three-vessel + secondary vessels, coronary artery disease. As it happens only in 8% of people worldwide, the left circumflex (LCD) artery is the dominant artery. This is only statistics, and it is a normal variable. Now, usually, the treatment recommendations vary from one clinic to another and from one country to another. If she was my patient, and if there was acute ischemia, I would treat only the culprit artery of the heart attack in the first time, with an angioplasty and stent placement. In a second moment, i.e. two weeks later, I would treat the two remaining blockages, the one in the mid-LAD and the one in D1 with stents, if suitable and if in a favorable position. If there was no acute myocardial infarction, and the three arteries would be suitable targets for stents, I would treat them with stents all at once. Even with all these said, there is no invasive cardiologist in the world that would be sure without seeing the angiogram film. There are detailed things that should be best discussed with the operator that carried out the procedure. There is one sure thing: the recommendation is that something should be done about this three-vessel coronary artery disease, whether it is angioplasty+stenting, or coronary artery bypass grafting. I hope I was helpful. Take care.  