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A rare case of natural bypass from LIMA to LAD
  1. Biplab Paul,
  2. Pranab Kumar Biswas,
  3. Debojyoti Sarkar
  1. Department of Cardiology, R G KAR Medical College, Kolkata, West Bengal, India
  1. Correspondence to Dr Biplab Paul, Department of Cardiology, R G KAR Medical College, Room no-48, KB Hostel, Kolkata, West Bengal 70004, India; biplov_107{at}

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A 55-year-old male, diabetic, smoker, presented with sudden onset severe retrosternal chest pain along with sweating. His pulse was 96/min, Blood pressure140/90 mm Hg: chest was b/l clear, Cardiovascular system examination revealed no abnormality. Electrocardiography showed gross ST segment depression in lead 2, 3, augmented vector foot and V5, V6 and tropinin-T was elevated. Echo showed no regional wall motion abnormality. With ejection fraction 60% he was diagnosed as unstable angina. He was managed medically with heparin, aspirin, clopidogrel, β blocker, ACE-inhibitor and nitrates. He had undergone angiography …

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