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Case Summary:

• 72 years-old man.
• HTN, DL. Former smoker.
• COPD with bronchospasm.
• 2013: Unstable angina. Severe lesion in LAD. Revascularization with 1 DES.
• 2013-2023, persistent anginous chest pain. 4 coronary angiographies with no new lesions.
• Echo and stress echo with no abnormalities.
• EKG: SR, non-ST changes.
• Lab: Normal
• Drugs: AAS 100 mg, amlodipine, oral nitrates, ranolazine, and bisoprolol.

PLAN

1. CORONARY MICROVASCULAR FUNCTION WITH REGADENOSON
2. PROVOCATIVE TESTING CORONARY VASOSPASM