Patient Presentation and Initial Assessment
The 49-year-old female comes to the office with a complaint of chest tightness after being in freezing weather. The pain can be relieved by resting, and the patient also states she has trouble breathing. The family history points to a possibility of coronary issues.
Diagnostic tests and the examination reveal a history of smoking, dyspnea, excessive weight, hyperlipidemia, and hypertension. The review of the symptoms for the patient, FB, and the results of the performed diagnostics point to angina as the primary diagnosis. Additional tests are necessary to confirm or dismiss this decision.
Diagnostic Findings and Risk Factors for Angina
The evaluation of completed test results can support the diagnosis of angina. The patient has elevated cholesterol levels of moderate risk, which demonstrate hypercholesterolemia and hypertriglyceridemia. Both issues are common risk factors for the development of angina; these coronary issues may be linked to heart disease. They decrease one’s blood oxygenation, leading to chest pain (Joshi & De Lemos, 2021).
The patient’s dyspnea on exertion is another common symptom of angina, as muscles that do not receive enough oxygen cannot handle any physical activity (Ford & Berry, 2020). An abnormal stress test confirms this suspicion and further strengthens the diagnosis of angina. A normal electrocardiogram (EKG) result lowers the potential of a heart attack as a differential diagnosis (Ford & Berry, 2020). Moreover, it may exclude certain variants of angina, although more testing is necessary for that conclusion.
Additional Tests and Confirmation of Diagnosis
To confirm the diagnosis of angina, the patient may undergo additional diagnostic tests. Cardiac troponin levels may be checked to fully eliminate the risk of a myocardial infarction (Joshi & De Lemos, 2021). An X-ray may reduce the number of other potential conditions, but it would not clearly show angina. Coronary artery function tests are also necessary to support angina.
Finally, angiography – a tomography of the coronary arteries’ blood flow – is a staple that distinguishes heart disease from angina (Ford & Berry, 2020). Other diagnostics may be necessary in the case of unclear results. Nevertheless, the combination of angiography, blood tests of troponins, an X-ray, and coronary artery function tests should create a sufficient basis for diagnosis.
References
Ford, T. J., & Berry, C. (2020). Angina: Contemporary diagnosis and management. Heart, 106(5), 387-398. Web.
Joshi, P. H., & De Lemos, J. A. (2021). Diagnosis and management of stable angina: A review. JAMA, 325(17), 1765-1778. Web.