Rate dependent left bundle branch block with angina pectoris and normal coronary arteriograms

A 46-year-old man developed rate-dependent left bundle-branch block and angina pectoris with effort. Angina pectoris and left bundle-branch block could be provoked with treadmill exercise testing and right atrial pacing. Coronary arteriograms were entirely normal on two separate occasions. The syndrome of angina pectoris with normal coronary arteries can include rate-dependent left bundle-branch block.