Case #1 Answers:













Answer 1

1.     Diabetes

2.     Hypercholesterolemia

3.     Smoking

4.     Family History














Answer 2

1.     Obesity

2.     Sedentary Lifestyle

3.     Lipoprotein A

4.     Low HDL













Answer 3












Answer 4













Answer 5

1. Fasting lipid panel
2. EKG
3. Chest Xray













Answer 6

Acute myocardial infarction

The WHO defines an acute myocardial infarction as two of the following three qualities
1. Hx compatible with angina (SSCP, worse with exertion, relieved with rest)
2. Cardiac enzyme leak
3. EKG changes compatible with cardiac muscle damage













Answer 7














Answer 8

In the setting of experience interventional cardiologists, there is evidence that coronary angiogram with angioplasty is better than thrombolytic therapy. If, however, the intervention is anticipated to be greater than four hours after the initial insult, thrombolytics are just as beneficial













Answer 9

Left main disease
Three-vessel disease with left ventricular dysfunction











Answer 10

1. ACE-inhibitor
2. Statin
3. B-blocker
4. ASA











Answer 11
1. ACE-inhibitors are used to prevent LV remodeling
2. Statins (Hmg-CoA reductase inhibitors) are used with a target goal of < 100. Some authors would recommend a target goal of < 75 for certain high risk patients
3. B-blockers should be titrated to keep BP to symptoms and/or a HR ~ 60 70.
4. Any patients with known CAD should be on an ASA












Answer 12
Cardiac rehabilitation
Smoking cessation counseling










Answer 13

1. 2d-echocardiogram
2. Stress testing