Cardio 5 Cases Flashcards
What is the management for a 50-year-old diabetic and hypertensive patient with exertional chest pain for 3 months?
Diagnosis: Likely stable angina due to coronary artery disease (CAD).
Investigations:
- ECG: Look for ST depression or T-wave inversion, indicating ischemia.
- Stress test: If the ECG is normal, a pharmacological stress test may be done.
- Coronary angiography: If the patient has severe angina or significant ischemic changes during the stress test.
Treatment:
- Aspirin and statins to reduce the risk of further events.
- Beta-blockers to control angina and reduce heart rate.
- Nitrates for immediate symptom relief.
- Revascularization (PCI or CABG) if stress testing shows significant ischemia or coronary blockage.
What is the management for a 60-year-old patient with known CAD and acute severe breathlessness and inability to lie flat?
Diagnosis: Likely acute left ventricular failure (LVF) or acute pulmonary edema.
Treatment:
- Oxygen: For hypoxia.
- Positioning: Sit the patient upright to reduce preload.
- IV furosemide: To reduce fluid overload.
- Morphine: For pain relief and venodilation.
- IV nitrates: To reduce preload and afterload.
- Inotropic support (e.g., dobutamine) if the patient has poor systolic function.
What is the management for a 25-year-old patient with fever and central chest pain for 5 days, raised JVP?
Diagnosis: Acute pericarditis complicated by pericardial effusion and possible cardiac tamponade.
Treatment:
- Pericardiocentesis: To remove excess fluid and relieve tamponade.
- Colchicine: To reduce inflammation and prevent recurrence.
- NSAIDs: For pain relief and inflammation.
- Treatment of the underlying cause (e.g., bacterial infection, if present).
What is the management for a 30-year-old woman with breathing difficulty one week after pregnancy?
Diagnosis: Peripartum cardiomyopathy or pulmonary thromboembolism.
Treatment:
- If peripartum cardiomyopathy: Treat as dilated cardiomyopathy with diuretics, ACE inhibitors, and beta-blockers.
- If pulmonary thromboembolism: Confirm diagnosis with pulmonary CT angiography and start anticoagulation therapy.
