<s>[INST] Hi I m a 47year old male who recently went for a myocardial perfusion scan and the results letter states; moderate severity stress induced ischemia within the anticipated distribution of the LAD but also within the RCA. The elevated TID ratio 1.26 may occasionally be a marker of balanced three vessel disease. My ECG showed that I also have got Left Bundle Branch Block. I have an appointment to see the Cardiologist next month but I am worried what to expect! Can you please give me some insight and is the TID ratio bad. I have tried my Doctor and Cardiologist with no joy!! [/INST] Abnormal values of the transient ischemic dilation ratio (TID) according to an exercise myocardial SPENT are linked to severe coronary artery disease. Abnormal values of the transient ischemic dilation (TID) ratio are associated with severe and extensive coronary artery disease (CAD). The mean TID ratio in patients with multi-vessel disease was 1.19. The threshold for an abnormal TID was 1.39 with specificity of 95% and sensitivity of 15% for determining multi-vessel CAD status. You may need Coronary angiography. </s>