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Stable angina — MCCQE Part 1 MCQ

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ModerateChest PainStable anginaMCCQE Part 1

61-year-old woman with dyslipidaemia presents with predictable chest tightness when climbing hills. Pain resolves within 5 minutes of rest, ECG is normal at rest and examination is unremarkable. Which of the following is the most appropriate next step?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Arrange non-invasive coronary assessment and optimise antianginal and cardiovascular risk therapy

Arrange non-invasive coronary assessment and optimise antianginal and cardiovascular risk therapy is best because exertional, relieved-by-rest pain is stable angina requiring risk stratification and prevention. Discharge after a single normal initial test is suboptimal because early cardiac disease can be missed by one isolated result; Arrange routine cardiology review without acute risk stratification is suboptimal because routine referral is too slow for a potentially unstable presentation; Give reassurance because the patient is young or previously well is suboptimal because age alone does not exclude serious cardiovascular disease; Treat only the symptom and omit ECG or biomarker-based assessment is suboptimal because cardiac presentations require objective assessment when suggested clinically. Stable does not mean benign; risk-factor treatment is part of the answer.

Reference: CCS chronic coronary syndrome guidance