1.

Salient features:
* Severe chest pain “ feeling of heaviness” radiating to left arm
* Breathlessness
* Profuse sweating

2.
Angina Pectoris Costochondritis GERD
Radiating Chest pain Deep breath Chest pain Heartburn
Chest pain neck,jaw, Cough Abdominal
Breathlesness/ shoulder, Radiate to pain
shortness of back back or No bloating
breath abdomen dtsphagia
sweating

3.Myocardial Infarction
4. Atherosclerosis

Endothelial injury: causes increased vascular permeability, leukocyte adhesion and

thrombosis.
Accumulation of lipoprotein in vessel wall: mainly LDL and its oxidized forms

Monocyte adhesion to endothelium: followed by migration to intima and

transformation into macrophages and foam cells.

Platelet adhesion

Factor release from activated platelets, macrophages, and vascular wall cells
including smooth muscle cell recruitement

Smooth muscle cell proliferation and ECM production

Lipid accumulation- both extracellularly within cells (macrophages and smooth
muscle cells).
5. Cardiac enzymes
6. Diagnostics:

12L-ECG – assess cardiac rhythm, LVH, prior MI

2D echo w/ doppler- most useful test for evaluation of ejection fraction or LV
function; semi quantitative assessment of alv size, function, wallmotion,, valvular
defects
Troponin test-
CPK-MB test- a cardiac marker used to assist diagnosis of an acute MI it levels blood
level of CKMB, the bound combination of two ariantts of the enzyme
phosphocreatinine kinaase.
Angiography- to isualize the inside or lumen of BV and organs of the body with
particular interest in arteries, veins, and heart chambers.

7.Management

Antiplatelets
- ASPIRIN- irreversible inhibitor of platelet cyclooxygenase activity, interfering
with platelet ctivation.
- Clopidogrel- blocks ADP receptor mediated platelet aggregation
ACE/ ARBS- RAAS inhibition
Reduces progression of atherosclerosis, plaque rupture, and thrombosis
- Telmisartan
- Losartan
Statins-act as HMGCoA reductase inhibitor
Exhibit plaque stabilization and anti-infammatory effects