Does an adult male who experiences chest discomfort during a predictable level of exertion (morning jog) that is promptly relieved by stopping activity and resting have stable angina?

Yes, This is Typical Stable Angina

This presentation meets all three diagnostic criteria for typical stable angina: substernal chest discomfort provoked by exertion (morning jog) and relieved by rest within minutes. 1, 2

Diagnostic Criteria Met

The European Society of Cardiology defines typical angina as meeting all three characteristics 1:

• Substernal chest discomfort of characteristic quality and duration - The patient has chest pain during activity 1
• Provoked by exertion or emotional stress - Symptoms occur during morning jog, a predictable level of physical exertion 1, 2
• Relieved by rest and/or nitrates within minutes - Pain resolves when he stops jogging and rests 1

Key Clinical Features of Stable Angina

The presentation aligns with classic stable angina characteristics 1:

• Duration: Brief episodes lasting no more than 10 minutes, commonly just a few minutes 1, 2
• Relationship to exertion: Symptoms appear with increased levels of exertion and rapidly disappear within minutes when activity stops 1
• Predictability: The pain occurs at a reproducible level of physical activity (morning jog), which is characteristic of stable disease 1, 2

Distinguishing from Unstable Angina

This is not unstable angina because 3:

• Pain is relieved by rest alone (unstable angina is defined as chest discomfort not relieved by rest and/or nitrates within minutes) 3
• Symptoms occur with predictable exertion rather than at rest or with minimal activity 3
• No mention of new-onset severe symptoms or crescendo pattern 3

Canadian Cardiovascular Society Classification

Based on the description, this likely represents CCS Class I or II 1, 2:

• Class I: Ordinary activity doesn't cause angina; angina occurs with strenuous or rapid or prolonged exertion 1
• Class II: Slight limitation of ordinary activity; angina on walking or climbing stairs rapidly 1

The morning jog suggests more than ordinary walking, placing this patient most likely in Class I 1.

Next Steps in Clinical Evaluation

While the history strongly suggests stable angina, confirm the diagnosis with 1:

• Assess cardiovascular risk factors: Age, sex, hypertension, diabetes, dyslipidemia, smoking, family history 1, 2
• Resting ECG: May be normal between episodes but essential baseline 1
• Stress testing: Exercise ECG or imaging stress test to confirm ischemia and risk stratify 1, 4
• Consider coronary angiography: Based on risk stratification and symptom severity 1

Important Caveats

The patient may not describe the sensation as "pain" - many patients use terms like pressure, tightness, heaviness, or discomfort 1, 2. Always ask specifically about "discomfort" rather than just "pain" 1.

Atypical features that would make this diagnosis less likely include 1:

• Pain lasting only seconds 1
• Pleuritic quality or reproduction with palpation 1
• Pain radiating to lower extremities 1
• No relationship to exertion 1