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Volume 332:125-127 January 12, 1995 Number 2
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Clinical Problem-Solving: Invasive Interventions

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 by Topol, E. J.
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 by Pauker, S. G.
To the Editor: With respect to the Clinical Problem-Solving article describing a young man requiring coronary angioplasty (Sept. 1 issue),1 we wish to take issue with the discussant's statement that "it is difficult to find much fault with either the diagnostic or the therapeutic approach." Despite a risk-stratification evaluation (involving normal results on a maximal stress test and a normal perfusion scan) that indicated his very low risk after an uncomplicated myocardial infarction, the patient underwent "obligatory" angioplasty for stenosis of the proximal left anterior descending coronary artery.

The physicians made only one objective measurement of the post-stenotic coronary blood . . . [Full Text of this Article]

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