A 80yo male with dementia and past history of CABG, two caths this year patent LIMA, totally occluded SVG to RPDA, SVG to OM2, s/p BMS to LCX, presents with increasing chest pain and nausea over the past few days. The patient has history of repeated episodes of recurrent chest pain with relief with morphine.  Pt is on ASA, Statins, Imdur, and Heparin. Last month’s cath showed patent BMS in LCX and no new lesions.  According to the family, the patient has increasing episodes of chest pain with minimal exertion in the last two weeks.