Chest Pain

Cardiovascular System

{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This patient demonstrates a classical presentation of chronic stable angina (CSA). Note that the resting ECG may be normal in this condition.\n\nHis exercise ECG confirms the clinical diagnosis by demonstrating the presence of myocardial ischemia. The coronary angiogram shows that this is due to significant stenosis of the left anterior descending artery (which supplies the bulk of the left ventricle).\n\nA reasonable next step would be myocardial revascularization via percutaneous coronary intervention (PCI). Antiplatelet therapy (e.g. with aspirin) and statin therapy (e.g. with atorvastatin) are other important aspects of his management.\n\nThere is no role for enoxaparin or troponin-T assays in his immediate management.\n"}]}

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