The case is reported of a 63-year-old white man with mild angina pectoris, whose systolic pressure fell 30 mmHg (4-0 kPa) with maximal exercise, without chest pain but with accompanying dizziness. Grafting the internal mammary arteries into the mid left anterior descending and obtuse marginal arteries improved regional myocardial perfusion and increased maximal cardiac output 24 per cent and maximal systolic pressure 32 per cent.
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