A middle aged man was admitted to hospital. He was diagnosed as having myocardial infarction, from which he made a good recovery, and he was discharged. Following review in medical out-patients, a stress ECG was undertaken, which showed minimal changes. With a strong family history, it was decided the patient should undergo coronary angiography. Cardiac catheterisation was undertaken via the right brachial approach. Following the procedure, the pulses in the right arm/hand were recorded as being faint, but the patient was discharged following review with an out-patient appointment following an exercise test. The cardiac catheterisation showed normal ventricular function and double vessel coronary artery disease.