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Total Occlusion of Left Main Coronary Artery Without Angina Pectoris

Nicholas L. DePace, MD; Demetrios Kimbiris, MD; Abdulmassih S. Iskandrian, MD; Charles E. Bemis, MD; Bernard L. Segal, MD
Arch Intern Med. 1983;143(5):1064-1065. doi:10.1001/archinte.1983.00350050234047.
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• A patient had total occlusion of the left main coronary artery that was proved by coronary arteriography. The patient was initially seen with clinical signs of congestive heart failure but without symptoms of angina pectoris or ECG evidence of myocardial infarction. The patient's extensive right-to-left coronary artery collaterals may have contributed to the absence of chest pain. Because of the severe left ventricular dysfunction and the absence of chest pain, the patient was treated with medical therapy. Six months after the cardiac catheterization, he was alive and well under New York Heart Association functional classification II.

(Arch Intern Med 1983;143:1064-1065)


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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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