zakaria asked:
Bob is a 40 year old male. He eats a Big Mac everyday for dinner. After that, he goes home, studies for 3 hours while smoking and goes to bed. He repeats this kind of lifestyle everyday.
Significant family history: Bob’s father died of a heart attack at the age of 54. His mother smokes and suffers from emphysema.
Last night, Bob had a sudden onset of sharp pain on the middle portion of his back and his left arm, accompanied by nauseation, shortness of breath and dizziness. He was sent to ER
first thing i would do is give him sublingual nitroglycerin, aspirin and put him on oxygen.
i would order CBC,
chemistry panel,
serial cardiac enzymes level (troponin, LDH),
ECG for abnormal heart rhythms,
chest CT for possible disecting aneurysm (any history of high blood pressure?),
echocardiogram.
depending on the results of these tests, may order cardiac stress test and/or catherize the patient.
Change the eating habits and speak to the family doctor.
Find out if Bob wants to be buried or cremated, and what color suit he wants to wear….he’s a walking time bomb (plus a major idiot given his family history for obvious heart disease and chronic smoking). I have no empathy.
Bob should quite smoking and stop eating the Big Macs, he could have had a heart attack or it could have been from stress of studying too much.
Bob should get checked out for any thing he knows of that his family has a history of.