New advances in the management of acute coronary syndromes: 1. Matching treatment to risk

Fitchett, David; Goodman, Shaun; Langer, Anatoly
May 2001
CMAJ: Canadian Medical Association Journal;5/01/2001, Vol. 164 Issue 9, p1309
Academic Journal
Mrs. D is a 58-year-old woman who presents to the emergency department because of a 2-hour episode of tightness in her chest, which had spontaneously resolved 1 hour before her arrival at the hospital. She has adult-onset diabetes mellitus and hypercholesterolemia, both of which have been controlled with medications. Her blood pressure is normal (120/75 mm Hg), as are the other findings at physical examination. An electrocardiogram (ECG) shows T-wave flattening in the lateral leads and a 1.5-mm T-wave inversion in leads II, III and aVF. The creatine kinase (CK) level and CK MB fraction are normal, but the cardiac troponin I level is 0.9 [mu]g/L (lower limit of detection 0.3 [mu]g/L). The emergency physician assesses Mrs. D's risk status and decides on treatment.


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