Special Purpose Examination (SPEX) [spex-exam]

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A 55-year-old guy visits his doctor because of his sporadic chest problems. It occasionally happens during effort and occasionally at rest, and it typically lasts 5 to 10 minutes. With some radiation to the throat, it is midsternal. He has a history of hypertension. He ceased smoking roughly at age 50. His only prescription is 10 mg of amlodipine daily. His type 2 diabetes and hypertension run in the family and his height is 70 inches, his weight is 210 pounds, and his blood pressure is 135/85. His pulse is also regular at 76. There are no cardiac rubs or murmurs audible, and his chest is clear. The overall evaluation is unfavorable. He has a normal electrocardiogram (ECG). What logical step would result in the best chance of a diagnosis?

Hemoglobin A1c Lipid profile Coronary angiography Technetium Tc-99m Sestamibi stress test

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Technetium Tc-99m Sestamibi stress test

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