The patient has been diagnosed with bp and lvh few yrs back and has been on medication telsar and amdopin.yearly checkup was done recently... TMT positive for induced ischemia. With 2mm depression at v4,v6,3 and 4.no pain Ecg positive for lvh And echo normal Tyroid activity has spiked ..with tsh at 9.46, t3-1.01 ,t4 reading is 8 ( no tyroid problem earlier) while ldl cholesterol 124.6- and HDl cholesterol -30 What further Investigation needed...like angiogram etc? Please guide.