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A 59-year-old man was admitted for evaluation of mild exertional angina in the morning. During graded treadmill exercise stress testing, the patient had reproducibly intermittent chest pains associated with ST-segment elevations in leads II, III and aVF. A baseline coronary angiogram showeda coronary narrowing of90%in the middle segment of the right coronary artery. The coronary narrowing was immediately resolved by an intracoronary injection of nitroglycerin. This was a very rare case ofdoi:10.2169/internalmedicine.34.597 fatcat:wi546bmuajhm3ovtwrvkq3xscq