QqqqqQ(Self made question27) - sweety_usmle

[ArchivalUser]

A 45 year old female is brought to your clinic with complains of occasional episodes of substernal chest pain that wakes her up during sleep. She cannot justify the nature of the pain whether stabbing or crushing. The pain lasts for around 30 mins and then resolves spontaneously. There is no history of illicit drug use neither HTN or diabetes. Her vitals are P: 80bpm, BP: 130/70 mm go Hg, RR: 14 and T 98F. You decide to do EKG monitoring which shows transient ST segment elevation in I, aVL, v4-v6 during the episodes. Which of the following is the most appropriate treatment ?

A. Propanolol
B. Aspirin
C. Digoxin
D. Dilitazem
E. Simvastatin
F. Heparin
G. Streptokinase

[ArchivalUser]

D? Prinzmetal Angina?

[ArchivalUser]

B
Sounds like prinzmetal angina, but this can only be confirmed w coronary angiography, so until then treat as any pt presenting with acute chest pain and STEMI
Once you confirm prinzmetal, can treat w Ca2+ channel blocker e.g. diltiazem to prevent coronary vasospasm
?

[ArchivalUser]

Prinzmetal so D?

[ArchivalUser]

DD

[ArchivalUser]

Answer "D"
This is Prinzmetal's Angina
Can anyone explain why?

Hope this was helpful

[ArchivalUser]

D.

Prinzmetal's Angina
Intermittent nature (lasts for only 30 mins)
ST elevations in leadss
No RF for MI (as HTN not present)

[ArchivalUser]

thanks