Lesson 3 of 9

Angina – Chest Pain


A 69 year old male presents to the emergency room complaining of increasingly severe chest pain for the past 2 hours. He has a 45 pack year history of cigarette smoking. Medications include thiazide, captopril and atorvastatin.


  • Describe the patient.
  • What is the chief complaint and differential diagnosis?
  • Describe the blood supply of the heart.
    • Normal structure and local regulation
    • Adaptation
    • Ischemia (supply vs demand)
    • Atherosclerosis
      • Pathogenesis
  • Describe types of plaque
    • Stable plaque (& CPC)
    • Unstable plaque (& CPC)
  • Describe the clinical-pathologic correlation:
    • What next?
    • EKG results:
      • What is the interpretation and next action? (3)
  • Describe the natural history for an acute STEMI (CPC)
  • How should the patient be treated?