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Clinical Problem-Solving
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Volume 341:1458-1462 November 4, 1999 Number 19
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Heart or Head?
William A. Gray, M.D., Douglas M. Barrett, M.D., and J. William Benge, M.D.

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A 65-year-old woman was referred to a cardiologist for the evaluation of progressive chest pain. Placement of an aortobifemoral conduit had been performed 14 years earlier for occlusive aortoiliac disease. She had smoked two packs of cigarettes a day for over 40 years. Her history of chest pain was typical of crescendo angina pectoris on exertion, without symptoms that were prolonged or that occurred at rest. Two years earlier, she had had a transient ischemic attack consisting of facial droop and aphasia. She had bilateral carotid bruits, which were greater on the left side than on the right, and a . . . [Full Text of this Article]

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From the Swedish Heart Institute, Seattle (W.A.G.); and Presbyterian Hospital, Albuquerque, N.M. (D.M.B., J.W.B.).

Address reprint requests to Dr. Gray at the Swedish Heart Institute, 1221 Madison St., Suite 1020, Seattle, WA 98104, or at williamg@swedishheart.org.

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