title: Relief of angina pectoris when carrying heavy loads with the left hand in a patient with previous coronary artery bypass graft operation who has severe exercise angina: a case report.
abstract: In patients with known coronary artery disease and/or a history of revascularization, angina pectoris or unstable coronary syndromes are usually attributed to the progression of atherosclerotic lesions rather than an unrecognized great vessel disease. However, for patients with a previous coronary artery bypass graft operation (CABG), during which a left internal mammary artery (LIMA) conduit has been used, great vessel disease, especially subclavian artery stenosis should also be suspected. We present a case of a patient with a LIMA conduit who has angina pectoris on exertion, but interestingly the pain is relieved when he carries heavy loads with his left hand, which can be due to increased blood flow to the LIMA conduit during heavy lifting because of increased peripheral resistance.
authors.affiliation: Gazi University, Department of Cardiology, Besevler Ankara, Turkey. aslitanindi@gmail.com
authors.forename: Asli
authors.initials: A
authors.lastname: Tanindi
authors.forename: Atiye
authors.initials: A
authors.lastname: Cengel
authors.forename: Ahmet
authors.initials: A
authors.lastname: Akyel
authors.forename: Sinan
authors.initials: S
authors.lastname: Akinci
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D000800:Angioplasty, Balloon / Q000295:instrumentation; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003326:Coronary Circulation; D058686:Coronary-Subclavian Steal Syndrome / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D015444:Exercise; D007839:Functional Laterality; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D009119:Muscle Contraction; D018482:Muscle, Skeletal / Q000098:blood supply*; D012039:Regional Blood Flow; D015607:Stents; D034941:Upper Extremity; D014655:Vascular Resistance; D014661:Vasoconstriction; D014664:Vasodilation