Metabolic antianginal agent ranolazine offers good symptom relief in a patient with inoperable severe aortic stenosis.

Severe inoperable aortic stenosis is a challenge for clinicians. Management of symptoms with traditional antianginal agents, which exert hemodynamic changes often may not be possible in such patient groups. We report the first known case of the safe use of ranolazine with good symptomatic relief of angina in an 88-year-old lady with isolated severe aortic stenosis (without significant coronary disease) who was not suitable for surgical or percutaneous valve replacement due to medical comorbidity.