| Symptoms
& History
Physical
Findings
Stop
& Think
Lab
and X-Ray
Differential
Diagnosis
The
Disease
Treatment
Conclusions
Quiz
& Evaluation |
|
Prinzmetal's
angina, diagnosis and management.
Diagnosis:
Transient ST segment elevation during pain is the key.
-
Ambulatory
EKG monitoring to detect episodes.
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Coronary
angiography to assess degree of atherosclerosis..
-
Provocative
testing during angiography using ergonovie or acetylcholine to induce transient
spasm.
Management:
Vasospasm, fixed obstructions and risk factors.
-
Nitroglycerin
for acute episodes.
-
Nifedipine
for longer lasting control.
-
Calcium
channel blockers.
-
Get 'em
to stop smoking and treat hypercholesterolemia, hypertension etc.
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Bypass
graft or angioplasty helpful only in the case of significant fixed obstruction.
What do
we recommend for Mr. Raymond?
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