CARDIOLOGY(D)

 A1.

Evolution of symptomatology :

  • 12yrs ago- diagnosied with DM.
  • 1yr ago  - has heartburn like symptoms which are relieved without medication
  • 7months ago- diagnosed with TB nd took treatment
  • 6months ago- diagnosed with HTN 
  • 1/2 hour back- SOB grade 4
Anatomical localization in this patient is Heart.
primary etiology is partial bloakage in coronary artery.

A2.
INDICATIONS:

  • Acute ST-elevation myocardial infarction (STEMI)
  • Non–ST-elevation acute coronary syndrome (NSTE-ACS)
  • Unstable angina.
  • Stable angina.
  • Anginal equivalent (eg, dyspnea, arrhythmia, or dizziness or syncope)
  • High risk stress test findings.      
    •   
    CONTRAINDICATIONS:
  • Intolerance for oral antiplatelets long-term.
  • Absence of cardiac surgery backup.
  • Hypercoagulable state.
  • High-grade chronic kidney disease.
  • Chronic total occlusion of SVG.
  • An artery with a diameter of <1.5 mm.

  • A3.
  • when PCI is  performed in pt. who does not need it ..it lead to complications.
    • Harms of over treatment:
    Economy, Planet, Security, World and Health. But an epidemic of overtreatment — too many scans, too many blood tests, too many procedures — is costing the nation’s health care system at least $210 billion a year, according to the Institute of Medicine, and taking a human toll in pain, emotional suffering, severe complications and even death.

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