Q101) A 65 y/o man with presents to your office with complaints of exertional chest pain for the past 4 weeks. The chest pain is usually left sided, occurs on walking about one block and goes away with rest. He denies any chest pain now. He also reports no change in quality or intensity of his chest pain He also reports having been diagnosed with peripheral arterial disease about 2 months ago for which he was advised exercise therapy. He does experience leg pain on walking about one block which also improves with rest. His past medical history is significant for moderate COPD, Hypertension and a hernia repair about 3 years ago. His medications include lisinopril, hydrochlorthiazide and tiotropium inhaler. Physical examination is benign. The next best step in establishing the diagnosis in this patient is :
A) 2 D -Echocadiogram
B) Exercise Stress Test ( Treadmill Stress Test)
C) Dobutamine Stress Echocardiogram
D) Persantin Stress Test
E) Cardiac Catheterization
C
D
d
CC
c
C) Dobutamine stress test
C
cause COPD
c
c.Dobutamine stress Echocardiogram
***Persantine causes Bronchospam-Contraindicated in COPD
c
B exercise stress test
COPD is a factor which favoring the Myocardial perfusion imaging, so the answer i……D
c, no dipyridamol, cause b constriction and he cant not walk.