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A calcified occlusion of the left main coronary artery in a young man
  1. R J G PETERS,

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    A 19 year old man was successfully resuscitated from ventricular fibrillation that occurred during exercise. Stress testing induced severe global ischaemia of the left ventricle. Coronary angiography (left) showed a normal right coronary artery (long arrow) that perfused the left coronary artery through peripheral collaterals (short arrows). At the site of the left main coronary artery, a dense radio-opaque mass was seen (curved arrow). On aortography, no antegrade flow of contrast through the mass into the left coronary artery could be seen (right, mass indicated by arrow). At the age of 2 years the patient had been hospitalised for 6 months because of a severe febrile illness with a generalised rash, for which no diagnosis was established at the time. The findings on angiography combined with this history suggest Kawasaki disease. The left internal mammary artery was grafted to the left anterior descending artery, and the patient made a full recovery.

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