A 63 year old diabetic patient comes to your office complaining of Chest discomfort, occurring after he eats. He smokes a pack of cigarettes a day. He was talking with a nurse friend of his who suggested that he have a stress test. On further questioning you find out that he has cramping pain in his legs when he walks 100 yards but it is promptly relieved upon resting. His only medication is an Albuterol inhaler that he uses no more than twice a day.

Your advice to him should consist of which ONE the following choices:

1. He should take an aspirin a day and that might relieve him.
2. He should be immediately sent to the ER for further workup of his chest discomfort
3. Further testing is not required but he should be started on Omeprazole for 1 month.
4. Smoking might be causing this and he should quit this.
5. Start an aspirin and get stress testing done as an out-patient.