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A 75-year-old man was admitted with sudden onset central chest pain, which was provoked by lifting a heavy bookcase. He had been asymptomatic since coronary artery bypass grafting (CABG) eight years previously. This included left internal mammary artery (LIMA) graft to his left anterior descending artery (LAD) and saphenous vain grafts to the obtuse marginal artery (OM) and right coronary artery (RCA). His cardiac risk factors were …