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Posted: July 27th, 2022

Assignment 12: Risk for coronary heart disease

Assignment 12: Risk for coronary heart disease

The patient was a 48-year-old man admitted to the coronary care unit complaining of substernal chest pain. During the 4 months preceding admission, he noted chest pain radiating to his neck and jaw during exercise or emotional upsets. The pain dissipated when he discontinued the activity or relaxed. The results of his physical examination were essentially normal except for a systolic murmur heard best at the apex of the precordium and radiating into the left axilla.

Studies

Results

Routine laboratory work

Within normal limits (WNL)

Cardiac enzyme studies

Creatine phosphokinase (CPK), p. 167

235 units/L (normal: 55–170 units/L)

CPK-MB, p. 171

12 ng/mL (normal: 0–3 ng/mL)

Lactic dehydrogenase (LDH), p. 293

120 units/L (normal: 90–200 units/L)

Serum aspartate aminotransferase (AST), p. 107

24 International units/L (normal: 5–40 International units/L)

Troponins, p. 451

18 ng/mL

Echocardiography, p. 820

Hypokinetic portion of the lateral left ventricle

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