Question

Mr. K. is a 57-year-old man who consulted his physician after noticing marked leg pains while playing golf. He had previously noticed increasing fatigue and discomfort in his legs associated with moderate exercise. When sitting for extended periods with legs dangling, his legs became red, and sometimes his feet felt numb. His history indicates he smokes cigarettes and is chronically overweight. His blood cholesterol and other lipid levels are abnormal, and his physician suspects peripheral atherosclerosis as the cause of his discomfort.

1. Discuss the development of atherosclerosis, including the predisposing factors in this case and the pathophysiological changes. (See Atherosclerosis.)
2. Discuss the complications that might develop in this patient. (See Atherosclerosis—Pathophysiology, Signs and Symptoms.)
3. Discuss the treatments for all aspects of the patient’s condition, including slowing the progress of the atherosclerosis, maintaining circulation in the leg, and treating complications. (See Atherosclerosis—Treatment.)

Mr. K reports that the sharp pain started about 2 days ago and it has gotten so bad that he cannot lie down. He rates the pain as an 8 on a scale of 1 to 10, and it radiates to his neck and back. It is much worse when he takes a deep breath, but leaning forward seems to help him. Family history is significant for heart disease and hypertension

4. What labs would be helpful in confirming or ruling out a myocardial infarction, and what are the advantages of each?
5. If Mr. H has acute coronary syndrome, what ECG changes are expected?

Answer 1

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