Case 42-1974

Presentation of CaseA 51-year-old woman was admitted to the hospital because of coronary-artery disease.She was well until 13 years previously, when episodic chest pain developed, and a diagnosis of angina pectoris was made. During the ensuing years the chest pain gradually became more frequent and responded less well to nitroglycerin, and dyspnea and orthopnea developed. Two months before admission she entered another hospital because of an episode of severe chest pain. Serial studies revealed no evidence of acute myocardial infarction. A coronary angiographic examination showed complete occlusion of the right coronary artery 1 cm from its origin; it . . .