Question

A 55-year-old man presents to the clinic with complaints of

chest pain. He states that for the past 5 months he has noted intermittent substernal chest pressure radiating to the left arm. The pain occurs primarily when exercising vigorously and is relieved with rest. He denies associated shortness of breath, nausea, vomiting, or diaphoresis. He has a medical history significant for hypertension, diabetes, and hyperlipidemia. He is taking atenolol for his high blood pressure and is eating a low-cholesterol diet. His family history is notable for a father who died of myocardial infarction at age 56 years. He has a

50-pack-year smoking history and is currently trying to quit.

His physical examination is within normal limits with the exception of his blood pressure, which is 145/95 mm Hg, with

a heart rate of 75 bpm.

Based on the above case address the following questions.

1) What is the likely diagnosis of this case? Explain, how would you classify the disease clinically?

2) Define the disease and what are the most common causes of this Is disease likely in the patient?

3) Are there any risk factors for the disease? If yes, then write down the common risk factors of the disease?

4) What lifestyle changes could make a difference for this patient?

5) Discuss the public health approaches in reducing and in the prevention of health problems.

Answer 1

Answers are:

1) Likely diagnosis is a stable angina. A stable angina occurs due to exertion and goes away with rest.Pain is typically substernally and radiating to left arm,jaw,shoulder or back.May or may not be associated with other features like shortness of breath

2)Angina occurs due to less blood supply to the heart thus leas oxygen to the heart muscles. Diabetes, hypertension and hyperlipidemia are all causes of angina in this patient.

3)Common risk factors include Hypertension, Hyperlipidemia, Diabetes, Smoking, elderly, family history of heart disease, sedentary lifestyle, obesity, excessive stress

4) The most important is making diet changes, following Proper diet with low fat, low carb, moderate protein, lots of fruits and vegetables, low sodium diet.

Exercise is very important 30 mins atleast thrice a week. Weight control.

Meditation and yoga to control stress.

Cut down smoking and eventually quit smoking