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Stable angina — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)Stable anginaUSMLE Step 3

A 58-year-old man has stable angina despite metoprolol. He has exertional chest pressure twice weekly that resolves with rest. Blood pressure is 126/74 mm Hg, pulse is 58/min. Coronary angiography 1 year ago showed nonobstructive disease. Which of the following is the most appropriate next step in management?

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

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Correct answer: A — Add a long-acting nitrate

When beta-blocker therapy is limited by bradycardia and angina persists, an additional antianginal such as a long-acting nitrate may be used.

Reference: ACC/AHA chronic coronary disease guideline