Question 4 · LEK · Chronic coronary syndromes
A 62-year-old patient with arterial hypertension and type 2 diabetes presents at his family doctor office because of a retrosternal stubbing pain that occurs after going upstairs to the first floor. The symptoms started about 6 weeks ago. Medical examination shows no significant abnormalities. The ECG records regular sinus rhythm 70/min without changes within ST segment or T wave. Indicate the correct management of this patient:
- A. referring the patient to the cardiology ward in order to exclude myocardial infarction and to perform urgent coronarography.
- B. referring the patient to the cardiology outpatient clinic in order to schedule the planned coronarography.
- C. referring the patient to the cardiology outpatient clinic in order to perform non-invasive stress echocardiography.
- D. referring the patient to the cardiology outpatient clinic in order to perform stress test ECG.
- E. patient does not need any further diagnostics.
Hint
Stable exertional symptoms, a normal ECG and high pretest probability — choose the non-invasive test favoured by current guidelines.
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