Evaluating asymptomatic patient

[Angioplasty]

---

Members do not see this ad.

Age 70-75, female, HTN current (multiple meds), DM (diet control), CKD, Obese, Dyslipidemia (on statin-LDL <100, HDL >60), Asymptomatic (may not be able to do 4METS), Echo EF NL, Mild LVH, Grade 1 diastolic function, EKG (LVH with non specific T wave inversions); FRS 10 year risk is 32.5%. How would you manage this patient for cardiovascular disease?

stress test?
Calcium score?
CT angio?
Aggressive medical therapy with risk factor modification
Coronary angiogram (just kidding)

Suggestions welcome from Cards fellows and attendings?