Mrs. Jameson, a 60-year-old woman, comes into the clinic com…
Mrs. Jameson, a 60-year-old woman, comes into the clinic complaining of chest pain, which has occurred three to four times since her last visit 4 months ago. She describes the pain as a squeezing, substernal pressure that is worse after climbing stairs in her home. The pressure resolved after 2 minutes of rest. During the last two episodes, she felt like she had indigestion and became a bit nauseous. She is diagnosed with Angina. Medications: metformin 1,000 mg by mouth once a day, lisinopril 30 mg by mouth once a day Allergies: none known Social history: quit smoking 2 years ago; smoked 1 pack per day for 30 years (30 pack years); diet high in saturated fats; says she eats whatever she wants; attempts to exercise, walks one to two times a week; widowed for 2 years Past medical history: htn for 10 years; type 2 diabetes mellitus for 5 years Physical exam: Vital signs: temperature 98.0°F; pulse 76 beats per minute; respirations 20 per minute; blood pressure 130/76 mmHg. Answer the following questions: 1- Her labs reveal a high total cholesterol, a high LDL (170) and a normal HDL (60) and normal triglycerides (140). What does this mean in terms of cardiovascular risk? Describe the concept of density in terms of the lipid panel (2 points) 2- Describe the risk factors for coronary artery disease and the describe how atherosclerotic plaque develops (2) 3- Ms. Jameson is diagnosed with new onset stable angina. What additional or different symptoms would someone with unstable angina manifests in comparison to stable angina? (1)
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