🏥 USMLE Exam Prep

A 62-year-old male with a history of hypertension and hyperlipidemia presents with exertional chest pain that is increasingly limiting his activities despite optimal medical therapy with aspirin, a beta-blocker, and a statin. His ECG shows no acute ischemic changes, and cardiac biomarkers are negative. An exercise stress test reveals reversible ischemia in the anterior wall. Which of the following is the most appropriate next step in management?

A Increase the dose of his beta-blocker
B Initiate a long-acting nitrate
C Refer for coronary angiography with consideration for revascularization
D Schedule for an echocardiogram to assess left ventricular function

✓ Correct Answer: Option C

Despite optimal medical therapy, the patient has persistent, limiting angina and objective evidence of reversible ischemia. Revascularization via PCI or CABG should be considered after coronary angiography to improve symptoms and potentially prognosis.

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