Question

A 54-year-old woman presents in a hospital with complaint of chest pain associated with forceful activities. The pain is dull but poorly localized and disappears few minutes of rest. No history of smoking but there is a positive history of hyperlipidemia. and admits that she has not been following the recommended diet. There was family history of heart attacks and cardiac diseases. Physical examination reveal blood pressure of 150/95 mm Hg, and heart rate of 80 bpm and nothing else is contributory; an electrocardiogram is normal except for slight left ventricular hypertrophy.

a. what is your working diagnosis?

b. what are drug (s) of choice for the treatment? why

c. what counselling will you give to the patient

d. write a summary on your diagnosis

Answer 1

The patient has hypertension, hyperlipidemia, and family history of heart attacks and cardiac diseases as well as improper diet. These all are risk factors of cardiac diseases. Currently, patient presented with chestpain during physical activities which indicates angina pectoris.

Angina pectoris is the chest pain due to decreasd blood flow to the cardiac muscles. There are two types of angina pectoris. The stable and unstable angina. Stable angina usually occur during physical activities, lasts for few minutes and releaved by rest or medications. Unstable angina can be experienced during rest, last long time an will not be releaved by medication or rest.

a. The patient has chest pain which is releaved by restbwhich indicate the diagnosis of stable angina pectoris.

b. The patient can be prescribed with nitroglycerin ans statin therapy. Oral nitroglycerin is vasodilator which improve the coronary vasodilation and leads to increased blood flow to the cardiac muscles. It helps in immediate relief from chest pain.The statin will helps to control cholesterol levels in the blood and reduce risk of blockage of coronary artery.

c. The patient has high risk for heart attack. So the patient has to maintain a healthy lifestyle. She has to follow recommended dietary patterns of low fat and low sodium diet and exercise to control hypertension and blood cholesterol levels. The counseling wil be given to reduce the risk of heart attack with Proper diet and exercise.

d. Stable angina is most common type of chest pain due to decreasd oxygen supply to the cardiac muscle walls. The cause is the narrowing in the coronary artery. The temporary chest pain can be releaved by nitroglycerin and life style modifications can reduce further advancement of the condition to cardiac arrest. An ECG will be performed for differential diagnosis. Most if the time, the stable angina can be controlled by following proper life style modifications.