AKT Question Relating to Diagnosis of Angina

A 46-year-old man attends your surgery complaining of intermittent chest pain over the last 2 weeks. He smokes 20 cigarettes per day. He does not take any regular prescribed medication. Clinical examination and initial investigations reveal the following:

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Blood pressure	124/84 mmHg
Pulse	76 beats per minute
Resting 12-lead	Sinus rhythm, inverted
electrocardiogram (ECG)	T-waves in lateral leads
Fasting total cholesterol	6.1 mmol/l

You consider a diagnosis of stable angina and suspect a high likelihood of coronary artery disease.

According to current National Institute for Health and Clinical Excellence (NICE) guidance, what is the SINGLE MOST appropriate investigation to confirm or exclude a diagnosis of stable angina in this patient? Select ONE option only.

Computerized tomography (CT) coronary angiography

Exercise ECG

Invasive coronary angiography

Myocardial perfusion scintigraphy

Stress echocardiogram

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