Chronic Stable Angina

E.H. is a 45-year-old African American man who recently moved to the community from another state. He
requests renewal of a prescription for a calcium channel blocker, prescribed by a physician in the former

state.
He is unemployed and lives with a woman, their son, and the woman’s 2 children. His past medical history

is remarkable for asthma and six “heart attacks” that he claims occurred because of a 25-year history of

drug use (primarily cocaine). He states that he used drugs as recently as 2 weeks ago. He does not have any prior medical records with him. He claims that he has been having occasional periods of chest pain. He is unable to report the duration or pattern of the pain. Before proceeding, explore the following questions: What further information would you need to diagnose angina (substantiate your answer)? What is the connection between cocaine use and angina? Identify at least three tests that you would order to diagnose angina.

Sample Solution

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