Stable Angina: The Daily PANCE Blueprint

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Stable angina: The Daily PANCE Blueprint

A 56-year-old male with a history of type 2 diabetes mellitus, hyperlipidemia, tobacco usage, and coronary artery disease (s/p PCI) presents to your clinic for a well-visit check. He does have intermittent substernal chest pressure but said it is the same as last year. The chest pain is exacerbated by exertion and improves with rest and nitroglycerin. It only lasts about 2 minutes when it occurs. Which of the following is the most likely diagnosis?

A. Myocardial infarction
B. Stable angina
C. Unstable angina
D. Congestive heart failure
E. Mitral stenosis

Answer and topic summary

The answer is B. Stable angina

Stable angina is defined as chest pain that occurs due to fixed atherosclerotic lesions that narrow the major coronary arteries. The ischemia that results is from an imbalance between oxygen demand and blood supply. Risk factors include diabetes, hyperlipidemia, hypertension, smoking, age, and family history. Clinical features include chest pain (described typically as “substernal pressure” or “tightness”) that lasts <15 minutes and is brought on by exertion/stress and that is relieved with rest/nitroglycerin. Diagnosis can be made via stress tests or cardiac catheterization with coronary angiography. Treatment includes aspirin, statins, beta-blockers, nitrates, and risk factor reduction.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Cardiology ⇒ Angina pectoris (PEARLS) ⇒ Stable angina

Also covered in the Emergency Medicine PAEA Rotation content blueprint

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