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