This is a case report on a 63-year-old male referred with severe substernal chest discomfort,present at rest with minimal exercise (Canadian Cardiovascular Society grade Ⅳ angina).He had sustained three prior myocardial infarctions and underwent two coronary artery bypass grafting procedures.He had a permanent cardiac pacemaker.His medications included aspirin,long-acting nitrates,a calcium-channel blocker and an HMG-CoA reductase inhibitor.