CASE 5

CASE 5


INTRODUCTION


A 58-year-old male teacher notices the sudden onset of "chest tightness" when he walks across the parking lot to and from the school. The pain, which is localized over the sternum, goes away when he sits down. He does not experience any pain or discomfort at other times. He has mild hypertension, for which he is on dietary therapy. His cholesterol level is elevated. He does not smoke.


· What is the most likely diagnosis?

· What is the most likely mechanism for these symptoms?

· What are the complications and prognosis?

 

Likey diagnosis: Ischemic heart disease ?
Mechanism : Athesrosclerosis causing narrowing of coronary arteries hence increasing blood flow demand while working which could not be sufficiently provided by narrowed coronary arteries.
Complication: myocardial infarction , unstable angina ?

waiting for answers

 

ANSWERS TO CASE 5: Coronary Atherosclerotic Heart Disease


Summary: A 58-year-old man with mild hypertension and hyperlipidemia has "chest tightness" with mild exertion. He does not experience any pain or discomfort at rest.


· Most likely diagnosis: Coronary atherosclerotic heart disease.

· Most likely mechanism for these symptoms: Occlusive coronary vascular disease leading to ischemia of the myocardium.

· Complications and prognosis: Myocardial ischemia or infarction, depending on the extent of arterial blockage and underlying cardiac function. The prognosis is worse with underlying poor myocardial contractility.

 

most likey diagnosis unstable angina .
mech... less blood supply to heart ..
prognosis .. change to mi . usually good if treated in time