chest pain - woodywoodpecker

[ArchivalUser]

A 54-year-old man presents to the emergency department
with chest pain. He has had three episodes of
chest pain in the past 24 h with exertion. Each has
lasted 20“30 min and resolved with rest. His past medical
history is significant for hypertension, hyperlipidemia,
asthma, and chronic obstructive pulmonary
disease. He currently smokes one pack/day of cigarettes.
His family history is remarkable for early coronary
artery disease in a sibling. Home medications
include chlorthalidone, simvastatin, aspirin, albuterol,
and home oxygen. In the emergency department, he
becomes chest pain“free after receiving three sublingual
nitroglycerin tablets and IV heparin. ECG shows
0.8-mm ST-segment depression in V5, V6, lead I and
aVL. Cardiac biomarkers are negative. An exercise stress
test shows inducible ischemia. Which aspects of this patient™s
history add to the likelihood that he might have
death, myocardial infarction (MI), or urgent revascularization
in the next 14 days?
A. Age
B. Aspirin usage
C. Beta-agonist usage
D. Diuretic usage

[ArchivalUser]

ccc

[ArchivalUser]

C ?

I wish there was an option E: Family History...or F: Hypercholestrolemia...I would have picked one of them

:-)

[ArchivalUser]

CCC

[ArchivalUser]

The answer is B. Patients with unstable angina/non-ST-segment elevation
myocardial infarction (UA/NSTEMI) exhibit a wide spectrum of risk of death, MI, or urgent
revascularization. Risk stratification tools such as the TIMI risk score are useful for
identifying patients who benefit from an early invasive strategy and those who are best
suited for a more conservative approach. The TIMI risk score is composed of seven independent
risk factors: Age ≥65, three or more cardiovascular risk factors, prior stenosis
>50%, ST-segment deviation ≥0.5mm, two or more anginal events in

[ArchivalUser]

two or more anginal events in less than 24 h, aspirin usage
in the past 7 days, and elevated cardiac markers. Aspirin resistance can occur in 5“10% of
patients and is more common among those taking lower doses of aspirin. Having unstable
angina despite aspirin usage suggests aspirin resistance. Use of a beta-agonist and a diuretic
do not confer an independent risk for death, MI, or need for urgent revascularization.

[ArchivalUser]

THANX

[ArchivalUser]

thank you woodywoodpecker ... good question

[ArchivalUser]

cccc

[ArchivalUser]

hey australiangirls, i dont think you`re a doctor. you are just making fun of this forum