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Abstract: A 79-year-old female patient complained of chest tightness, chest pain, and shortness of breath with no obvious cause 2 days ago, and the discomfort became more pronounced after a little activity and was not relieved after rest, and was also accompanied by nausea, without dizziness, fever, numbness of the limbs, or abdominal pain.
Basic information】Female, 79 years old
Disease Type】Angina pectoris
Hospital】Senior Hospital of Central South University
Date of consultation】June 2022
Treatment plan】Medication (atenolol tablets, verapamil hydrochloride tablets)
Treatment Period】In-hospital treatment for 7 days, followed by discomfort
Effectiveness】The disease was controlled, and the symptoms of chest tightness, chest pain, nausea and shortness of breath disappeared.
I. Initial consultation
When I first saw the patient, he reported that two days ago he felt chest tightness, chest pain, shortness of breath, and a persistent feeling of suffocation, which became worse after a little activity, and was accompanied by nausea, without dizziness, fever, numbness of the limbs, abdominal pain, etc. He came to our hospital for further treatment because he could not be relieved after rest. The electrocardiogram showed that the patient had sinus rhythm, abnormal Q waves in some leads, left deviation of the electrocardiographic axis, and low T waves in some leads. After perfecting coronary angiography, the results were positive, and the diagnosis of angina pectoris was made by combining the patient’s clinical symptoms and laboratory test results.
II. Treatment history
I informed the patient of the diagnosis, and after full communication with the patient, I gave the patient medication. The patient’s disease was caused by a relative lack of blood supply to the myocardium. I first gave the patient atenolol tablets, which are beta-blockers and can lower the heart rate and blood pressure after entering the patient’s body, and also make the contraction of the myocardium and oxygen consumption decrease, which can effectively improve the patient’s chest tightness, chest pain, nausea and shortness of breath induced by angina pectoris. It can also be combined with verapamil hydrochloride tablets, which can reduce cardiac afterload and inhibit myocardial contraction, thus improving left ventricular diastolic capacity and relieving patients’ discomfort.
III. Treatment effect
On the first day of in-hospital drug treatment, the patient was clear and in good mental condition, reported normal diet and urination and defecation, and the symptoms of chest tightness, chest pain, nausea and shortness of breath were reduced, and no other obvious adverse symptoms were found. On the 3rd day of in-hospital medication, the results of the review were better than the previous one. On the 7th day of in-hospital treatment, the disease was under control, the symptoms of chest tightness, chest pain, nausea and shortness of breath disappeared, the heart rate was 80 beats/min, no pathological murmur was heard in each valve auscultation area, and there was no edema in both lower limbs.
IV. Precautions
As the patient’s condition was better controlled, I was sincerely happy for the patient, but at the time of discharge I still suggested that the patient should pay attention to the following points.
1, daily should be kept emotionally stable, so as to avoid excessive emotional ups and downs and increase the burden on the heart, can do some things that interest them, such as painting, singing, etc., can help to calm down the mood.
2, if after going home and reappearing with chest tightness, chest pain, nausea and other adverse symptoms, should promptly seek medical attention, I will clarify the causative factors through systematic examination and give the appropriate treatment modality.
3.Because of the patient’s age, I also suggest that the patient, as well as his family, should have regular medical checkups for the patient in order to keep an eye on his physical condition.
V. Personal insight
Early diagnosis and treatment of diseases are more important, just like the 79-year-old female patient in this case, she immediately sought medical examination when she found abnormal symptoms, and after the diagnosis of angina pectoris, she was treated with atenolol tablets and verapamil hydrochloride tablets. Both the patient and I were satisfied with the outcome of this treatment. In addition, I also recommend not to use medication randomly in order to prevent the wrong use of medication and damage their health.