Lesson 3, Topic 2

Angina – Chest Pain – Part 2

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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?

 

QU Angina.chest pain 8.12.20

 

KEY IMAGES:

- Heart, surface anatomy: artery blood supply

 

- heart, short axis view, regions of arterial supply of blood:

 

- heart, blood supply at the tissue level:

 

- heart, long axis view for conduction system and valves