Saagar Mahida

Chronic stable angina

A 73-year-old farmer with a 15-month history of stable angina presents for consultation. He has curtailed his farming activity to avoid chest discomfort, for which he uses nitroglycerin (0.4 mg sublingually) approximately 3 times per month. His heart rate is 59 beats per minute, and his blood pressure is 132/72 mm Hg. He had unstable angina 12 years earlier, and a drug-eluting stent was implanted in his left anterior descending artery; no other obstructive coronary artery disease was noted at that time. His medications include aspirin, lisinopril (20 mg daily) for hypertension, and atorvastatin (40 mg daily). How should this case be evaluated and managed?