IntroductionandPatientDescription,Assessmentofpatientswithanginapectorisisachallengefortheclinicalcardiologist.Myocardialischemiaandanginapectoriscanbecausedbyvariousmechanisms,suchascoronaryatherosclerosis,vasospasm,orcoronarymicrovasculardysfunction[1].Moreover,thesemechanismsmayoverlapinagivenpatient,makingitdifficulttodeterminethecauseofangina.Wereportherethecaseofa57-year-oldfemalepatientwithahistoryofanginapectoristhatstarted3monthspreviously.Hersymptomsoccurredpredominantlyatrestbutalsowitheffort.Thepatientwasanactivesmokerwhosmokedabout15cigarettesperday(~20packyears).Moreover,shehadhypertensiontreatedwithenalapril.HerLDLlevelwas75mg/dlwithoutanycholesterol-loweringtherapy.Shewassentfordiagnosticcoronaryangiographyforsuspectedstenosingcoronaryarterydisease.
