Stable angina — MCCQE Part 1 MCQ

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ModerateChest PainStable anginaMCCQE Part 1

A 63-year-old man has predictable central chest tightness when walking uphill that resolves within 3 minutes of rest; resting ECG and troponin are normal. Which of the following is the most likely diagnosis?

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Correct answer: B — Stable angina

Stable angina is the single best answer because the age, timing, examination findings and investigations in the vignette fit Stable angina better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to CCS chronic coronary syndrome guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: CCS chronic coronary syndrome guidance