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Background  Angina pectoris early after aortic valve replacement surgery in patients with previously normal coronary arteries may be life threatening and has to be assessed immediately.    Case report  12 weeks after aortic valve replacement surgery, a 60-year-old female patient was referred for evaluation of recent onset of severe chest pain on mild exertion and at rest. Coronary angiography showed severe stenosis nvolving the left coronary ostium and the left main stem. The patient was urgently referred for bypass surgery and had an uneventful postoperative recovery.    Conclusion  A high degree of suspicion is needed for early recognition and aggressive management of this rare but serious complication.

Unstable angina early after aortic valve replacement surgery in a female patient with normal coronary arteries preoperatively – a case report