Posts Tagged ‘Silent ischemia

5. a. men age 35 or over with family history of premature coronary artery disease b. age 35 or over with two or more major cardiovascular risk factors, (dyslipidemias, hypertension, diabetes mellitus and cigarette smoking). Of all patients with coronary artery insufficiency, the group of asymptomatic individuals with silent ischemia poses a major challenge in […]

The greater incidence of anginal attacks in the morning hours may be indirect evidence of increased coronary artery tone. The sympathetic stimulation that takes place upon awakening and arising is an important mediator of the increase in blood pressure, heart and myocardial contractil­ity which occur in the morning causing an increase in oxygen consumption and […]

1. d. local (cellular) metabolic changes e. decreased left ventricular compliance c. decreased left ventricular contractility b. increased left ventricular end-diastolic pressure a. electrocardiographic changes f angina. The temporal sequence of events that characterize an ischemic cardiac episode is best described as a “cascade” of abnormalities which begins at a cellular level and amplifies its […]

CASE 2 A 66-year-old woman with a history of atherosclerotic heart disease, adult onset diabetes mellitus and hy­pertension presented for a scheduled follow-up visit. She gave a history of rare episodes of stable exertional angina. Her therapeutic regimen included glyburide, hydrochloro­thiazide, low salt, calorie restricted ADA diet and sublingual nitrates. During the preceding three months […]

Case 1 A 49-year-old insurance executive was scheduled for an exercise tolerance test. The patient had no significant past medical history and was in excellent health. He jogged two miles regularly three times a week and played golf on weekends. Screening for hypercholesterolemia in the pre­ceding two years yielded values consistently under 200 mg/ dl. […]