Full 2L QBank
Medicine Acute coronary syndrome 94e9e49f

A 58-year-old man presents to you complaining of chest pain. The pain occurs when he walks to the corner shop on his lunch break and disappears within a couple of minutes when he stops to rest. He has never had pain at rest or pain that did not spontaneously remit.Clinical examination is normal except for mildly elevated blood pressure at 145/85. An ECG shows normal sinus rhythm. What is the most appropriate investigation?

A
Fasting blood lipids
B
Urgent invasive coronary angiography
C
Repeat ECG in 1 week
D
CT coronary angiography
High-Yield Explanation
Case of chronic stable angina Option A: Fasting blood lipids= Yes, It is mandatory to identify there is a presence of blockage in coronary aery secondary to hypercholesterolemia or any deranged lipid profile. But it is not most appropriate here. Option B: First we give patient medical treatment if it fails then only, we go for angiography so it is ruled out. Option D: CT Angiography = It can identify blockages in coronary aery with the high sensitivity .Nowadays we are using CT angiography over stress test.

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