Dear Dr. Singh,
I am referring Mrs. Jane Cooper, a 62-year-old woman with cardiovascular risk factors, for your evaluation of intermittent chest discomfort.
Mrs. Cooper has been experiencing episodes of chest tightness for the past two months, which are aggravated by exertion, such as climbing stairs or brisk walking. These episodes last for several minutes and are relieved with rest. She has not reported any associated sweating, palpitations, or syncope.
Her background history includes long-standing hyperlipidemia, for which she takes Atorvastatin 20 mg daily. She is also a smoker, with a 20-pack-year history, although she has reduced her intake recently. Her most recent blood pressure was 150/90 mmHg. On examination, her cardiovascular and respiratory findings were unremarkable.
Given the nature of her symptoms and her risk profile, I am concerned about possible stable angina. I would be grateful if you could assess her for further cardiac investigations, including ECG, echocardiography, or stress testing, and advise on the appropriateness of commencing anti-anginal therapy.
Meanwhile, I have reinforced the importance of smoking cessation, blood pressure control, and adherence to her current lipid-lowering therapy.
Thank you for your attention to this case.
Yours sincerely,
