Question

A 55-year-old man was brought to the emergency department by ambulance. He woke up at 6 AM feeling a crushing pain over his chest. He has had p of precordial pain, mostly while walking outside in cold weather or when running with his dog. As of late the pain would appear while he was at rest as well, but it was never as severe as now. He has diabetes and arterial hypertension for which he takes medication. He was given an aspirin and transferred to the coronary intensive care unit by 8AM Physical Findings: He is obese, short of breath, sweating, and obviously in acute distress. His pulse rate is 90 and the blood 100/60 mm Hg Laboratory and Clinical Findings At the time of admission the serum levels of myoglobin, troponin I and T, and creatine kinase MB were within normal lmits. The ECG showed sinus tachycardia, but no other abnormalities. Outcome: revious attacks pressure is He had a coronary angiography and a stent was inserted. He was treated for a few days in the coronary care unit and recovered completely. Questions 1. What is the pathogenesis and what are the possible causes of chest pain of sudden onset? 2. What is the significance of precordial pain that occurs during effort in contrast to precordial pain that occurs at rest 3. Is the history of diabetes and hypertension important for the understanding of the present illness of this patient? 4. Why was he given aspirin? 5. Is it possible that this patient has an MI even though the laboratory findings do not support that diagnosis? When could one expect a rise of serum levels of myoglobin, troponin, and CK-MB? 6. Is the ECG always abnormal in patients with acute MI?

I’m dying with this. I tried to find the information myself but I can barely write a comprehensive answer to most of these. I would be forever grateful if you could help me with this horrible assignment. I asked this before and the responder gave an incomprehensive and unreadable response so it did not help at all.

Answer 1

1)Precordial pain is a pain on chest where the underlying cause cannot be cardiac systems.The

Conditions like walking in the cold will constrict the blood vessels and and running will increase blood pressure with known case of Diabetes , arterial hypertension, obesity has resulted in the patient conditions

Some of the possible cause are

obesity which has a high chance of deposition of lipids on blood vessels leading to chest pain.

2) Precordial pain that occurs in a state of effort is due to the stimulation of the nerves or irritating it.

Precordial pain which occurs in rest is little worried because it has no triggers and might be related to heart.

3)Diabetes is a silent killer and one of the major cause for cardiovascular illness,additionally patient has arterial hypertension which helps in the diagnosis of the condition

4) Aspirin has a action of slowing down the process of any clot formation and decreasing its size and thereby preventing a second attack.