A case of coronary steal syndrome caused by a large unligated branch of the left internal mammary artery in a patient who had undergone myocardial revascularization is described. The presence of recurrent angina, a positive exercise stress test, and repeat angiography showing a lateral branch of the mammary artery led to a diagnosis of the coronary steal phenomenon. Surgical ligation of the branch was performed and the patient became symptom-free with a negative exercise stress test.
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