A 57-year-old moderately overweight Caucasian male visits his family physician w

Question

A 57-year-old moderately overweight Caucasian male visits his family physician with a symptom of “indigestion” of 5 days’ duration. He has also had bouts of sweating, malaise, and headache. His blood pressure is 140/105 mm Hg; his family history includes a father with diabetes who died at age 62 of AMI secondary to diabetes mellitus. An electrocardiogram revealed changes from one performed 6 months earlier. The results of the patient’s blood work are as follows...

1.   Can a diagnosis of AMI be ruled out in this patient?

2.   What further cardiac markers should be run on this patient?

3.   Should this patient be admitted to the hospital?

A 57-year-old moderately oveweight Caucasian male visits his family physician with a symptorn of "indigestion" of 5 days duration. He has also had bouts of sweating, malaise, and headache. His blood pressure is 140/105 mm Hg, his family history includes a father with diabetes who died at age 62 of AMI secondary to diabetes mellitus. An electrocardiogram revealed changes from one performed 6 months earlier. The results of the patient's blood work are as follows: CK CK-MB LDH LDH AST 129 U/L 4% 280 U/L Isoenzymes 35 U/L 46-171 UL ( LDH-2 (5-30) Question:s Can a diagnosis of AMI be ruled out in this patient? 2. What further cardiac markers should be run on this patient? 3. Should this patient be admitted to the hospital?

Explanation / Answer

in this question we are having an over weight hypertensive person with family history of diabetes along with chest discomfort and ECG changes..

so ...

1. Can a diagnosis of AMI be ruled out in this patient = no, there are chances of AMI as diabetic person is prone for silent MI,SO it can not be overlooked.

2. What further cardiac markers should be run on this patient = ...we can go for TROP T test for this patient as a immediate result ...other markers are. a, troponin I, Myoglobin, CKMB and LDH.

3. Should this patient be admitted to the hospital = AS this patient is associated with comorbidity and ECG changes so Definitely he must kept for observation.but here individual bias plays important role.

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