Summary

Question 1

discuss the final Write up with main points of focus:

Answer 1

50 year old woman (school counselor) with 3 episodes of Left substernal chest pain over the prior two weeks, rated 5 of 10 intensity with associated sweating and dyspnea.

1st episode persipiated by reading about a car crash reminding her of loss of her father

Pt had hypertension during pregnancy and a brief smoking history in her early 20’s, with strong family history of CAD

Mother passed from MI at age 62 and Brother coronary bypass at age 48 with no history of diabetes

-her physical examination is unremarkable, except for her BP 150/95

Question 2

Diagnostic condiderations

(Differential Diagnosis)

Answer 2

angina

panic attack

GERD

Musculosceletal chest pain

dissecting aortic aneurysm

Question 3

Diagnositc Workup includes?

Answer 3

EKG

Stress Echo

Trial of a PPI

Chest X-Ray

Behavioral Therapy