Rapid development of coronary arterial stenosis following valve replacement: an unusual cause of myocardial ischemia.

A 56-year-old woman had unstable angina pectoris 3 months after aortic and mitral valve replacement for rheumatic heart disease. Repeat coronary arteriography revealed critical proximal left anterior descending and circumflex artery stenoses in previously normal coronary arteries. This case emphasizes the need for thorough evaluation of postoperative valvular patients, despite normal preoperative coronary arteriograms.