T.N, fifty-six year old white male is hospitalized by his primary care physician for evaluation of chest pain brought on by walking uphill. Pain was described as crushing that never occurred at rest and was not associated with emotional stress, meals, or a particular time of day. The pain subsides when the patient stops walking or lifting.T.N's father died at age 58 of myocardial infarction and his brother died at 42 of coronary artery disease.

T.N. is 6' 2" tall, weighs 275 pounds, drinks three to four beers a day and chews tobacco.

Upon admission to the cardiac care unit, T.P. is in no apparent distress. Resting vital signs: supine blood pressure 158/95 mm Hg, pulse 72 beats/min (regular) and respiratory rate 12 breaths/min (normal: 8 - 14). There is no peripheral edema or neck vein distention. ECG reveals normal sinus rhythm with no evidence of previous myocardial infarction.

Admitting laboratory values were within normal limits.