A 42-year-old man was referred to the cardiologist’s office for an evaluation. The patient had recently started an exercise program for weight loss. For the last 3 weeks, following exercise, he had noticed radiating chest pain (angina pectoris) that stopped after rest. This condition had worsened in the last week. The cardiologist ordered a stress echocardiogram (a test that visualizes the heart during increasing stress). The echocardiogram results suggested that the patient had coronary artery disease (CAD). The patient was scheduled for a cardiac catheterization the next morning. It was noted in the patient’s chart that he smoked two packs of cigarettes per day. As you read this chapter, consider the following questions:

1			What symptoms suggest that this patient is suffering from coronary artery disease and not some other disorder?
2			Why is it important to test the heart under stress rather than obtaining a resting echocardiogram?
3			What lifestyle changes should this patient make to prevent future heart attacks?
4			Why is a cardiac catheterization needed in addition to the stress echocardiogram?
5			What are the treatment options for this patient?