The Heart of the Matter
My next patient is Jennifer Wilcox, who recently turned 67 years old. This is a follow up to a heart issue she was experiencing last Monday.
Looking at her medical record, I noticed that she spoke to our advice nurse on Monday morning, and complained about intermittent chest pains, clammy hands, and a rapid heartbeat. The advice nurse advised Jennifer to call 911. When she arrived at the hospital ED by ambulance, she was given an electrocardiogram, and a chest X-RAY. Nothing appeared to be out of the ordinary. The ED doctor wrote that the cause of the symptoms was unclear, and ruled out a heart attack.
I spoke to Jennifer the next day, and we decided to do a treadmill stress test. The result of that test was abnormal, but inconclusive. So I ordered a heart CT scan to see if we could pinpoint the problem. The finding was a very minor blockage in the left anterior descending artery. After speaking with a cardiologist, we decided to prescribe a statin drug; Lipitor. I also instructed Jennifer to start taking a low dose of aspirin daily.
Looking at Jennifer's past lab results, I can see that her LDL cholesterol was bit high. Her HDL cholesterol was within the acceptable range. Perhaps this was a contributing factor.
Dr. Tanaka: Hello Jennifer, how are you feeling?
Jennifer: Much better. My heart has not been racing like it was that night last week. I do feel a twinge of pain now and again in my chest. Not every day fortunately.
Dr. Tanaka: Let's keep an eye on that. Once you have been taking Lipitor for a while I think that will become less prevalent.
Jennifer: Will I have to take Lipitor for the rest of my life?
Dr. Tanaka: Yes, we want to prevent a major issue down the road, so you will need to take it indefinitely.
Jennifer: Well, I'm glad it was not too serious. I really thought I might need to have a stent inserted into one of my arteries.
Dr. Tanaka: Yes, that is definitely something we want to avoid. So Jennifer, to keep this from becoming more serious in the future, please eat as healthily as you can. Watch the snacks, keep the weight down, and get some exercise every day.
I listened to Jennifer's heart, and everything seemed to be normal. I wish all my heart patients were as healthy as Jennifer.
Flash Card Drill
- When he awoke he fell ill with an intermittent fever, but it went away by the end of the day.
- The weather forecast for today was for intermittent showers throughout the day, but in reality it was a sunny all day.
- After the stress test on the treadmill, John's heart took a long time to slow down.
- Because John's left anterior descending artery was partially blocked, we decided to insert a stent.
- The results of his initial exam were inconclusive. They will do the exam again in 3 weeks.
- Regarding Andrew's heart failure, well, he smoked for 40 years, so that was definitely a contributing factor.
- If your hands are constantly clammy and wet, something as simple as shaking hands can bring on anxiety.
- My doctor checks my cholesterol levels every year.
- I spoke to my cardiologist the other day after my exam, and he recommended I increase the dosage of my heart medication.
- I felt a twinge in my shoulder while playing basketball yesterday.
- My doctor prescribed a statin drug after he saw my cholesterol test results.
- My doctor looked at my EKG results and asked me to go to the hospital to have a stent inserted into one of my blocked arteries.
- The heart CT scan revealed blockages in two of my arteries, unfortunately.
- Mr. Smith's electrocardiogram showed some abnormal heart function that will need to be investigated further.
