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Angina during upper limb exercise: pathognomonic clinical feature of coronary–subclavian steal syndrome?

A 62-year-old patient, with a history of myocardial revascularisation consisting of a left internal mammary artery (LIMA) to the left anterior descending coronary artery (LAD) for significant coronary artery disease 16 years ago, was admitted with intermittent chest pain occurring only during physical activity of the left arm. The stress ECG up to 175 W was …