Office of Education
Yale University
School of Medicine
367 Cedar Street
300 ESH
New Haven, CT
06519 USA
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Cases | A Patient with Chest Pain
Questions
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What is your most likely diagnosis and why?
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Name at least 5 other common entities that need to be considered
in the differential diagnosis? What aspects of the history, physical,
laboratory features would you look for to suggest these other possibilities?
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Describe the anatomic blood supply to the heart and the basic pathogenesis
of cardiac ischemia.
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What major risk factors for ischemic cardiac disease? Which are particularly
relevant to this patient?
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Would there be any diagnostic benefit from doing an exercise stress
test on this patient? Describe the basic principles of this test. What
if the patient cannot exercise? What if his baseline EKG showed a left
bundle branch block?
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What are the major classes of medications available for this patient?
Describe their basic mechanisms of action, modes of administration and
potential side effects.
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Is coronary angiography indicated for this patient? What are its
major indications, benefits and risks?
- What would be an indication to consider coronary angioplasty or
bypass surgery? Describe their benefits, longterm success rates,
and risks.
Next: Discussion
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