A 80-year-old man with chronic stable angina, hypertension, and mild CKD (eGFR 56) presents to the GP with increased frequency of anginal episodes - n...

Question

A 80-year-old man with chronic stable angina, hypertension, and mild CKD (eGFR 56) presents to the GP with increased frequency of anginal episodes - now occurring 3-4 times weekly on exertion, previously once monthly. He is on Atenolol 50 mg daily and GTN spray PRN. What is the MOST appropriate next step?

Accepted Answer

Increase Atenolol to 100 mg daily and add a long-acting nitrate (e.g., Isosorbide mononitrate MR)

Answer

Stop Atenolol and start Verapamil

Answer

Refer for emergency coronary angiography

Answer

Prescribe regular Ibuprofen for the chest pain

Answer

Add Sildenafil for improved exercise tolerance

uk-dgm MCQ (SBA): Escalating Stable Angina - Dual Antianginal Therapy