Presentation of Case A 69-year-old man was admitted to the hospital because of severe epigastric pain. There was a history of coronary artery disease with an inferoposterior myocardial infarct 20 years earlier and four admissions to another hospital because of unstable angina pectoris during the ensuing 9 years. Angina persisted, and a coronary angiographic examination, performed elsewhere 9 1/2 years before entry, showed complete occlusion of the right coronary artery and high-grade obstruction of three other vessels. Seven years before admission an exercise-tolerance test was strongly positive. Six and a half years before entry the patient was seen at this. . .