A 75-year-old female, retired private duty nurse, has been complaining for the past 10 days of unprovoked classical attacks of angina 2 to 3 a day usually in the mornings. The angina occurs at rest and may last 5 to 10 minutes. On careful questioning she admitted to similar attacks during the previous 2 years, which were disregarded because they were infrequent (every 4 to 6 weeks) and shorter in duration. However, the attacks were also unprovoked and unrelated to any specific activity, emotional upset, or food intake. Family history revealed her father and mother died at age 72 and 78, respectively, of causes unknown, and her only sibling, a brother, died at age 74 of an acute myocardial infarction. Past medical history revealed symptomatic osteoarthritis of her large extremity joints. Periodically she obtained relief with two 325 mg aspirin tablets 3 to 4 times daily and lately had a...

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