Clinical Intake — Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris

A 62-year-old male with known coronary artery disease — including a prior drug-eluting stent placed to the mid-left anterior descending artery in 2022 for unstable angina — presented with a three-month history of recurrent chest tightness occurring with moderate exertion such as stair climbing and uphill walking, relieved by cessation of activity. He has been maintained on optimized guideline-directed medical therapy with controlled lipids, blood pressure, and glycemia; serial cardiac biomarkers are negative for acute injury, and left ventricular function was preserved on a recent cardiac evaluation. Despite full medical optimization including dual antiplatelet therapy, the exertional symptoms have persisted, and Dr. Mehta refers the patient for further specialist assessment to evaluate the functional significance of his coronary anatomy.