Anginal Pain And Normal Coronary Arteries

A 51 year old female non-smoker, applying for $350,000 of term insurance, provided a history of chest tightness beginning 15 months prior to her application. The discomfort was located retrosternally, occasionally extending to the left shoulder, and was usually associated with exertion or excitement. The lady reported having taken sublingual nitroglycerine for a period of several months with little relief. At the time of application she was taking nifedipine, 60 mg/day and was on no other medication. A paramedic examination recorded a height and weight of 5’6" and 153 potmds. Her blood pressure was initially 148/90, falling to 132/78 at the conclusion of the exam. Routine blood chemistry screening and urinalysis were entirely normal. A resting EKG revealed low tO fiat T waves in I, AVL and V6 but was otherwise normal.