Case #1 Answers:

 

 

 

 

 

 

 

 

 

 

 

 

Answer 1
 

1.     Diabetes

2.     Hypercholesterolemia

3.     Smoking

4.     Family History

Hypertension



 

 

 

 

 

 

 

 

 

 

 

 

Answer 2
 

1.     Obesity

2.     Sedentary Lifestyle

3.     Lipoprotein A

4.     Low HDL


 

 

 

 

 

 

 

 

 

 

 

 

Answer 3
High
 

 

 

 

 

 

 

 

 

 

 

 

Answer 4
~20%

 

 

 

 

 

 

 

 

 

 

 

 

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
 

ASA
Heparin
Nitroglycerin
Oxygen
 

 

 

 

 

 

 

 

 

 

 

 

 

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