Case 1.

Mr. J.p, 62 years old, overweight, smoker dairy farmer, is hospitalized for
evaluation of chest pain. About 3 weeks before admission, he noted
substernal chest pain brought on by lifting heavy objects or walking
uphill.
He describes a crushing pain that never occurs at rest, When J.P. stops
working, the pain subsides in about 5 minutes.
Mr. JP have a family history of CVD.

Q1. What signs and symptoms does J.P. exhibit that are consistent with the
diagnosis of chronic stable angina?

Q2: What risk factors for CAD are present in J.P.? Which of these may be
altered?

Q3. What is/are the best medication for this Mr. J.p?

During the first hospital day, J.P. decides to walk up three flights of stairs
when returning to his room from the cafeteria instead of taking the
elevator. Midway through the third flight of stairs J.P. develops chest pain.
After quickly performing a 12-lead ECG, the physician instructs J.P. to
place a 0.4-mg sublingual (SL) NTG tablet under his tongue, which
relieves his chest pain.

Q4: What instructions should J.P. receive with regard to the use and of SL NTG?
How rapidly will SL NTG relieve J.P.’s chest pain?
Case 2.
Mr. Hatem, 40 years old, overweight, smoker accountant, went to the
hospital suffering from a chest pain occurred at rest, 3 times in the last 2
weeks.
He describes the pain that is like a sharp stabbing knife in the shoulder
and back. Mr. Hatem have a family history of CVD.

Q1. What is the type of angina does Mr. Hatem exhibit and why?

Q2. What is/are the best medication for this Mr. Hatem?