Q96) A 65 year old man with history of DM type II presents to your office with complaints of chest pain that he has been having lately. He denies any pain now. He says his chest pain is more left sided and about 5/10 in intensity and it appears after walking about 2 blocks. The pain disappears after resting for a while. He has been having these chest pain episodes for the past 3 months. He also reports severe crampy leg pain that occurs in his both legs which is also relieved by rest. He denies any shortness of breath. He has smoked about 1 pack per day for the past 40 years. He denies any cough. His only medications are Glyburide and Metformin. An EKG is obtained in the office and it reveals non-specific ST segment changes. Next important step in managing this patient:
A) CT angiogram of Chest
B) Exercise Treadmill Stress test
C) Obtain Cardiac Enzymes
D) Dipyridamole Stress test
E) Start Calcium Channel Blocker
D
It is a stable angina, which needs further work up
answer = B
a- Angiogram should be done after a stress test to check disease extension decide treatment
c- Patient is asymptomatic now, it does not look like MI
e- CCB, not a first like agent ( patient is asymptomatic)
D
cause PDA
d cause leg pb
d
b’cos cant do tradmill