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A 70-something female with no previous cardiac history presented with acute chestpain. She awoke from sleep last night around 4:45 AM (3 hours prior to arrival) with pain that originated in her mid back. She stated the pain was achy/crampy. Over the course of the next hour, this pain turned into a pressure in her chest.
CT Coronary Artery Calcium Score Scan CT Coronary Artery Calcium Score CT CoronaryAngiogram As you can see from the above images, the CTCA provides far more anatomical detail. Regardless, if you present with chestpain and get a stress test instead of a CTCA, you are arguably getting an inferior test.
A 63 year old man with a history of hypertension, hyperlipidemia, prediabetes, and a family history of CAD developed chestpain, shortness of breath, and diaphoresis after consuming a large meal at noon. He called EMS, who arrived on scene about two hours after the onset of pain to find him hypertensive at 220 systolic.
No prior exertional complaints of chestpain, dizziness, lightheadedness, or undue shortness of breath. He denied headache or neck pain associated with exertion. I sent this ECG to Dr. Smith, with the only information that it is a 17 year old with chestpain. 24 yo woman with chestpain: Is this STEMI?
Riskfactors such as high blood pressure, smoking, and inactivity are important because the longer you are exposed to them, the higher the odds you will develop coronary artery disease sooner in life. And, by extension, have a higher risk of a heart attack. But not everyone with riskfactors develops early heart disease.
Knowledge of this fundamental pillar of biology should drive how cardiologists approach men and women being evaluated for the presence of significant coronary disease. Atypical angina is classified as having any two of the three symptoms, and non-anginal pain any one of the three symptoms. versus 66.3%; P =0.004), older age (62.4±7.9
But the symptoms returned with similar pattern – provoked by exertion, and alleviated with rest; except that on each occasion the chestpain was a little more intense, and the needed recovery period was longer in duration. It’s judicious, then, to arrange for coronaryangiogram. CoronaryAngiogram 1.
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