USMLE forum
Step 1
Step 2 CK
Step 2 CS
Matching & Residency
Step 3
  <<   < *  Step 3   *  >   >>  

* Cardio????????
  mounika1980 - 01/03/17 23:13
  A 32 year old had presented to office with complaints of recurrent chest pain .The patient describes pain as a substernal squeezing pressure which occurs during exertion, lasting for 5 minutes and is not relieved by rest.Past,Personal,Family history is unremarkable.Physical examination revealed mildly anxious patient ,no pallor,cyanosis or clubbing.Chest auscultation was normal.There were no Audible murmurs.

B.P= 120/70

An EKG preformed was normal.
CXR= Normal

What is the next best step ?

A Reassurance

B Angiography

C Stress EKG

D Endoscopy
Report Abuse


* Re:Cardio????????
  heartlocker - 01/03/17 23:47
  C Stress EKG

Symptoms s/o Unstable Angina.
Though anxiety could be a d/d which would be a probability after -ve Stress EKG.

A Reassurance if Stress EKG -ve

B For the age with no family history and normal EKG(and without stress EKG results), Angio can be awaited for Stress EKG results.

D Endoscopy --the nature of pain warrants a stress EKG then later we can perform one to rule out GERD/PUD
Report Abuse

* Re:Cardio????????
  qikjon - 01/10/17 21:03
Report Abuse

* Re:Cardio????????
  witchdoctor - 01/10/17 21:15
  she has a low pretest probability of heart disease , less than 10% so I only reassure and no further testing is required  
Report Abuse

* Re:Cardio????????
  witchdoctor - 01/10/17 21:19
  sorry , the question doesn't say if a male or female patient
if female she has low pretest probability of CAD---REASSURANCE
if male he has an intermediate pretest probability of CAD--- stress EKG
Report Abuse

* Re:Cardio????????
  helperimg2014 - 01/11/17 12:30
  I would look at the TIMI score and make a decision. Agree with above answers. In the real world, doing nothing, is like working on a recipe for a lawsuit.  
Report Abuse

          Page 1 of 1          

[<<First]   [<Prev]  ... Message ...  [Next >]   [Last >>]

Logon to post a new Message/Reply




Step 1 Step 2 CK Step 2 CS Matching & Residency Step 3 Classifieds
LoginUSMLE LinksHome