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This case describes a 78\u2010year\u2010old male with an 11\u2010h history of chest tightness. A reduction was observed in the extent of localized ventricular pre\u2010excitation, accompanied by secondary ST\u2013T segment abnormalities in leads V1\u2013V3. Emergency coronary angiography revealed occlusion of the left anterior descending artery. 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