Case Study: Mr.

David Johnson - Angina

Patient Information:

Name: Mr. David Johnson

Age: 58 years

Gender: Male

Medical History: Hypertension, Hyperlipidemia, Type 2 Diabetes Mellitus

Presenting Complaint:

Mr. David Johnson presents to the emergency department with complaints of chest discomfort. He
describes the pain as a pressure-like sensation in the center of his chest that started about 30
minutes ago. He reports that the pain has not radiated to his arms or jaw but is associated with
shortness of breath.

Initial Assessment:

Upon arrival, Mr. Johnson appears diaphoretic and anxious. His vital signs are as follows:

Blood Pressure: 160/90 mmHg

Heart Rate: 90 beats per minute

Respiratory Rate: 20 breaths per minute

Oxygen Saturation: 95% on room air

Diagnostic Tests:

Electrocardiogram (ECG):

ST-segment depression in leads V4-V6, indicative of myocardial ischemia.

Cardiac Enzymes:

Troponin levels are within normal limits.

Diagnosis:

Suspected Angina Pectoris

Treatment:

Mr. Johnson was promptly started on the following treatments:

Oxygen therapy via nasal cannula

Sublingual nitroglycerin for chest pain relief

Aspirin 325 mg orally

Beta-blocker (metoprolol) for rate control and to reduce myocardial oxygen demand

Statin therapy (atorvastatin) for lipid management

Questions:

1. Define angina pectoris and describe its typical presentation.

2. Discuss the pathophysiology of angina pectoris, including the role of coronary artery disease.
3. What are the common risk factors associated with angina pectoris in Mr. Johnson's case?
4. Interpret the findings on Mr. Johnson's ECG and explain how they support the diagnosis of
angina pectoris.
5. Discuss the potential complications associated with angina pectoris and their management.
6. What lifestyle modifications would you recommend for Mr. Johnson to reduce his risk of
recurrent angina episodes?
7. How would you educate Mr. Johnson about the signs and symptoms of angina pectoris and
when to seek medical attention?