Adult female with instable angina, several cardiovascular risk factors and intermittent Left Bundle Branch Block

• Female 52-year-old
• History of stable angina for 8 years related to physical strain
• Progression in recent months with more frequent events to minor strain
• Before admission, she presented more prolonged episode accompanied by syncope
• Risk factors: hypertension, DM2 and smoking
• She takes: aspirin, simvastatin 40 mg and glybenclamide 5 mg
• Normal electrolytes and biomarkers

Questions:

1. Which is the clinical-electrocardiographic diagnosis?
2. Which is the most appropriate approach?