Problem description: I was admitted to the hospital for “chest tightness and pain after intermittent work for 1 year, and then another half an hour”. In the past 1 year, the patient often felt chest pain during fieldwork. It is located behind the breastbone, which is a tight pain, and can relieve itself after rest. Not taken seriously, diagnosed and treated. Half an hour ago, the chest pain recurred while working in the field, so his son was taken to the hospital for treatment. The patient’s usual diet has a strong taste, and he likes braised pork in brown sauce, which must be eaten almost at every meal. Smoking for 50 years, about 30 cigarettes/day in recent years. He has lived in the countryside for a long time, has never had a physical examination, and denied the history of “hypertension, diabetes, coronary heart disease”. Physical examination: Consciousness, blood pressure 150/90mmHg, heart rate 80 beats/min, regular rhythm, no murmur. Check blood lipid analysis: triglycerides 4.5mmol/L, high-density cholesterol 1.3mmolL, low-density cholesterol 6.8mmolL; coronary CTA showed: near anterior descending artery soft plaque, stenosis 75%. Admission diagnosis: unstable angina pectoris, hyperlipidemia. Questions: 1. Can analgesics be used before clarifying the cause of chest pain, such as analgesics, which medicine to choose? 2. Patients with elevated triglycerides and low-density cholesterol, which lipid-lowering drugs can be selected? 3 .How to relieve the pain of angina patients, and what long-term medication plan should be formulated?
Question date:2021-04-14
Patient information:Age : 441 years old Gender: Male
Problem analysis: Hello, from the examination results, coronary artery stenosis is relatively serious.
Guide suggestion: In this case, when the effect of medication is not good, stent therapy needs to be considered.
Recommendations are for reference only. If the problem is serious, please go to the hospital for detailed inspection