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

Case presentation

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

Question

Which is the clinical-electrocardiographic diagnosis?

Which is the most appropriate approach?

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