Angina pectoris: The Daily PANCE Blueprint

Home Angina pectoris: The Daily PANCE Blueprint

Angina pectoris: The Daily PANCE Blueprint

A 72-year-old male with a history of tobacco abuse (30 pack years) and hypertension presents to the clinic with dyspnea on exertion for the past few weeks. He also says he was mowing the lawn and had some chest pressure that was relieved with rest. His vitals are stable. Physical and cardiac exam is unimpressive. Which of the following is the best initial diagnostic test?

A. Cardiac catheterization
B. Nuclear stress test
C. Cardiac MRI
D. Chest x-ray
E. Echocardiogram

Answer and topic summary

The answer is B. Nuclear stress test

Angina pectoris is defined as retrosternal chest discomfort, pressure, or tightness specifically due to myocardial ischemia. It is the cardinal symptom of coronary artery disease and can be triggered by anything that increases myocardial oxygen demand. Angina usually occurs when coronary artery stenosis is about 70% or greater. Angina is further classified as stable vs unstable (not relieved by rest or nitro, new-onset, or worsening). Nuclear stress testing is the most widely used test for the diagnosis of ischemic heart disease in those with symptoms of angina.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Cardiology => Angina pectoris (PEARLS)

Also covered as part of the Emergency Medicine EOR and Internal Medicine EOR topic lists

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