Lesson 3, Topic 6

Angina – Chest Pain – Part 6

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Materials

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?