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IMS 423 CASE HISTORIES ON ISCHEMIC HEART DISEASE

IMS 423 CASE HISTORIES ON ISCHEMIC HEART DISEASE. Dr. Zahoor. Q1. What is your clinical diagnosis? Q2. What advice you will give to the patient? Q3. What first investigation you will do? Q4. If ECG is normal, what other investigation you will advise?. Q1. What is your clinical diagnosis?.

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IMS 423 CASE HISTORIES ON ISCHEMIC HEART DISEASE

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  1. IMS 423CASE HISTORIES ON ISCHEMIC HEART DISEASE Dr. Zahoor

  2. Q1. What is your clinical diagnosis? Q2. What advice you will give to the patient? Q3. What first investigation you will do? Q4. If ECG is normal, what other investigation you will advise?

  3. Q1. What is your clinical diagnosis?

  4. Case History # 3 Q1. What level of cholesterol is indicated in patient with coronary artery disease?

  5. Case History # 4 Q1. What will be your next investigation?

  6. Case History # 5 Mr C is a 40 year old Chinese salesman, who works very hard and is under much stress to sell. He suffers from mild hypertension and is under treatment, though not very regular. One month ago, while jogging, he experience an unusual, tight band-like discomfort, over his chest. He began to sweat profusely, cold sweat. He felt dizzy. Realizing that something was not right, he called his colleague who was nearby, to come and help him. While he rested in the car, the colleague informed Mr C's wife, and drove him to the emergency room of a nearby medical center.

  7. An ECG done there confirmed that he had indeed taken a heart attack. Mr C's ECG on arrival at emergency room, showing acute ST elevation suggestive of acute myocardial ischemia. An ECG done there confirmed that he had indeed taken a heart attack. Mr C's ECG on arrival at emergency room, showing acute ST elevation suggestive of acute myocardial ischemia.

  8. The cardiologist there decided to perform an immediate angioplasty (primary angioplasty). Mr C had total occlusion of his LAD artery. This was treated with a coronary stent. He had chest pains at about 10am. He reached the medical center at 11.30am, and the cardiologist opened the artery and implanted the stent at about 12.30noon (2hrs 30mins after the onset of chest pains). He was discharged about three days later showing full recovery of the heart muscle that was initially damaged. His ECG was virtually normal.

  9. Q1. In a patient with ST elevation MI, what is the first choice of treatment? PCI Thrombolytic therapy

  10. Thank you

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