8th February 2022

A 60-year-old woman comes in for a review

A 60-year-old woman comes in for a review. She is known to have heart failure. She says that she has been experiencing some chest pain over the past months, especially when she goes for walks with her dog, that is solved when she has rested for 5 minutes. Her observations are all normal with no change in body weight. Her heart rate is 82 with blood pressure of 157/80mmHg.

On examination, heart rate is regular with normal heart sounds. JVP is not raised and no respiratory crackles. There is noticeable pitting oedema surrounding her ankles.

You perform an ECG which shows no signs of a myocardial infarction.

Her medications include:

• Ramipril 10mg
• Furosemide 40mg

What would be the best medication for this patient experiencing exercise-induced chest pain?

Select the SINGLE most appropriate option from the list below. Select ONE option only.