A 58-year-old woman presents to your cardiology clinic with a 6-month history of intermittent chest discomfort. She describes the sensation as a pressure-like tightness in the center of her chest. This occurs primarily with moderate exertion, such as walking up two flights of stairs or carrying groceries. The discomfort is sometimes associated with shortness of breath. It typically resolves within 5 to 10 minutes of resting. She has tried sublingual nitroglycerin once, provided by a friend, with minimal relief. Her medical history is significant for hypertension, diagnosed 7 years ago, and hyperlipidemia. She has been adherent to her medications, lisinopril and atorvastatin. Her father had a myocardial infarction at age 62. She is a former smoker, having quit 15 years ago, and consumes alcohol socially. She denies any illicit drug use.

Initial laboratory studies are as follows:

WBC: 7,500/mm³ (4,500-10,000)

Hemoglobin: 13.5 g/dL (12.0-16.0)

Platelets: 250,000/mm³ (150,000-400,000)

Na⁺: 140 mEq/L (136-146)

K⁺: 4.2 mEq/L (3.5-5.0)

Creatinine: 0.9 mg/dL (0.6-1.1)

Troponin T, high sensitivity: <5 ng/L (<14)

Total Cholesterol: 160 mg/dL (<200)

LDL: 85 mg/dL (<100)

HDL: 55 mg/dL (>50)

Triglycerides: 100 mg/dL (<150)

Glucose: 95 mg/dL (<100)

hs-CRP: 2.5 mg/L (<3.0)