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A 62-year-old man is referred by an orthopedic surgeon for a preoperative evaluation for elective left hip arthroplasty. He has a history of coronary artery disease with stable angina for many years. He uses nitroglycerin about twice a month. His exercise capacity is severely limited because of the pain in his hip. Current medications include aspirin 81 mg daily, atenolol 50 mg daily, and simvastatin 40 mg. His pulse rate is 72 beats per minute, blood pressure is 132/84 mm Hg, and results of cardiac examination are normal. What is the most appropriate next step in the patient's cardiac evaluation before his planned surgery?
a. Initiate B-adrenergic blocker therapy and proceed with operation.
b. Initiate nitrate therapy and proceed with operation.
c. Perform dobutamine echocardiography.
d. Perform treadmill exercise testing.
e. Perform coronary angiography.c. Perform dobutamine echocardiography.
d. Perform treadmill exercise testing.
