ENGLISH

MEDIC
ALISSON OJEDA AMPA
FILIATION
Patient name: V.A.P
Gender: male
Age: 72
Race: Mestiza
Place of birth: Lima
Place of residence: Lima - San Borja
Occupation: Marine
Address: San Borja
Marital status: married
Identification document: 08649023
Religion: Catholic
Language: Spanish
Phone: 947882319
Form of appearance: sudden
Evolution: progressive
Main signs and symptoms: oppressive chest pain, diaphoresis and
paleness.
Patient goes to the emergency room at the Daniel Alcides
Carrion Hospital with chest pain, which began at approximately
9 a.m.
The pain travels to the left arm and there is a burning sensation
in the stomach like indigestion, with an intensity of 6/10, which
increases with movement and decreases when at rest. The
patient reports that he took aspirin to relieve the pain, it worked
for a few hours, but then the pain intensified even more. He also
tells us that he felt pain in his shoulder and it traveled to his jaw.
He realized that this pain appears after doing physical activities.
In the last hours, increased pain with an intensity of 9/10 that
radiates to the shoulder and jaw, which causes difficulty
breathing.
Site Center of the chest

Onset Sudden

Character Pressure type

Radiation Shoulder and jaw

Pain in the arm, shoulder,

Accompanying symptoms
jaw and difficulty breathing

Timing 9 hours

Increases with movement

Exarcebating factors Calm to rest and with aspirina

Severity 6/10
DIFFERENTIAL
DIAGNOSES
 STABLE ANGINA
DEFINITION PATHOPHYSIOLOGY
It is chest discomfort or pain that in most
Coronary stenosis stable atherosclerotic disease,
cases occurs with activity or emotional stress.
which limits coronary flow, with an imbalance between
oxygen supply and demand.
EPIDEMIOLOGY

The incidence ranges from 0.7% in men aged

45 to 54 years to 4.3% at ages 85–89 years,
and in women, from 0.4 to 4.2%, respectively.

RISK FACTOR'S

Advanced age
Tobacco use
Diabetes
High blood pressure
 STABLE ANGINA
CLINICAL PICTURE TREATMENT
Chest pain feels like stiffness, tightness, Treatment of angina may include the following:
squeezing or constricting pain.
Changes in lifestyle
DIAGNOSIS Medicines
Angioplasty and stenting
Electrocardiogram.
Open heart surgery (coronary bypass surgery)
Chest x-ray.
Blood test.
stress test
Echocardiogram
 UNSTABLE ANGINA
DEFINITION PATHOPHYSIOLOGY
It is chest pain that is sudden and often
Unstable, vulnerable or high-risk plaque, which can
worsens for a short time.
rupture and induce platelet adhesion and thrombus
formation.
EPIDEMIOLOGY

The incidence ranges from 0.7% in men aged

45 to 54 years to 4.3% at ages 85–89 years,
and in women, from 0.4 to 4.2%, respectively.

RISK FACTOR'S

Advanced age
Tobacco use
Diabetes
High blood pressure
 UNSTABLE ANGINA
CLINICAL PICTURE TREATMENT
Chest pain feels like stiffness, tightness, Prehospital care: oxygen, aspirin, nitrates, and referral
squeezing or constricting pain. to an appropriate medical facility.
Pharmacological treatment: antiplatelet agents,
DIAGNOSIS anticoagulants, antianginals and, in some cases, other
drugs.
Serial ECGs Angiography to evaluate the anatomy of the coronary
Serial measurement of cardiac markers artery.
Immediate coronary angiography in patients with Reperfusion therapy: percutaneous coronary
complications (eg, persistent chest pain, intervention (PCI) or myocardial revascularization
hypotension, unstable arrhythmias) surgery.
Late angiography (between 24 and 48 hours later) Rehabilitation after medical discharge and chronic
in stable patients medical treatment of coronary heart disease.