USMLE Forum Archives - USMLE Step 2 CK - Cardiology
Cardiology
Youngdoctor - 03-25-07 02:36
Obese patient, smoker (20 cigarettes a day) presents with 3 hours of retrosternal chest pain, which improves with rest. He has a past history of intermittent chest pain, which improved with rest or nitroglycerine. His pain is improving as you see him. He belched and felt better. Initial cardiac enzymes are normal. What is the next step in management:
a) refer to gastroenterologist
b) send him home with reassurance asking him to come next day
c) arrange an immediate exercise stress test
d) admit him to CCU and monitor his ECG and do serial cardiac enzymes
e) send him home and ask him to come when worse
Youngdoctor - 03-25-07 02:36
Obese patient, smoker (20 cigarettes a day) presents with 3 hours of retrosternal chest pain, which improves with rest. He has a past history of intermittent chest pain, which improved with rest or nitroglycerine. His pain is improving as you see him. He belched and felt better. Initial cardiac enzymes are normal. What is the next step in management:
a) refer to gastroenterologist
b) send him home with reassurance asking him to come next day
c) arrange an immediate exercise stress test
d) admit him to CCU and monitor his ECG and do serial cardiac enzymes
e) send him home and ask him to come when worse
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#2
Re: Cardiology TheOne - 03-25-07 19:27 This patients' Hx and Risk factors indicates a sever Coronary Artery Disease (CAD), the 3 hours chest pain can not be left without any observation or Rx.
Answer C should be done & its' results should be used to follow up the patient.
#4
Re: Cardiology babbu5508 - 07-07-10 00:05 c) arrange an immediate exercise stress test...he might be having angina as shown by the history, which should be ruled out first...
#5
Re: Cardiology sagheerahmed - 04-10-11 15:56 D, pt should b admited in ccu for monitoing bcoz pt have allready angina and on off chest pain history relived by sublingual nitrates
#6
Re: Cardiology babbu5508 - 04-11-11 10:49 Obese patient, smoker (20 cigarettes a day) presents with 3 hours of retrosternal chest pain, which improves with rest. He has a past history of intermittent chest pain, which improved with rest or nitroglycerine. His pain is improving as you see him. He belched and felt better. Initial cardiac enzymes are normal. What is the next step in management:
c) arrange an immediate exercise stress test
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