Week 5 Discussion Pharm Coronary artery
disease
Week 5 Discussion Pharm Coronary artery disease
For this questions, please read the following case stud and then
respond to the questions noted below.
Mr. EBR is a 74-year-old retired Hispanic gentleman with known
coronary artery disease (CAD), who presents to your clinic with
substernal chest pain for the past 3 months. It is not positional; it
reliably occurs with exertion, approximately one to two times daily,
and is relieved with rest, or one or two sublingual nitroglycerin
(NTG) tabs. It is similar in quality, but is much less severe, than the
chest pain that occurred with his previous inferior myocardial
infarction (MI) 3 years ago. Until the past 3 months, he has felt well.
The chest pain is accompanied by diaphoresis and nausea, but no
shortness of breath (SOB) or palpitations. He does not vomit. He
denies orthopnea, paroxysmal nocturnal dyspnea (PND), syncope,
presyncope, dizziness, lightheadedness, and symptoms of stroke
or transient ischemic attack (TIA). An echocardiogram done after
his MI demonstrated a preserved left ventricular ejection fraction
(LVEF). Other medical problems include well-controlled type 2
diabetes mellitus (DM), well-controlled hypertension (HTN), and
hyperlipidemia, with low-density lipoprotein (LDL) at goal. He also
has stage 3 chronic kidney disease (CKD) and diabetic neuropathy.
He no longer smokes and does not use alcohol or recreation
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