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EACH PATIENT - AN OPEN BOOK

Interesting Clinical Cases

Dr. R.V.S.N.Sarma., M.D., M.Sc., (Canada)5 Jayanagar, Tiruvallur 602 001

Mobile 93805 21221Visit us at : www.drsarma.in

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Clinical Problem Young Engineer in LANCER Car factory Sudden H/o of Angina – incomplete relief Can be easily ignored What was wrong ? How he was investigated ? What was the outcome ?

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Clinical Issues identified ECG changes not classical of MI or IHD Pain is very typical of effort angina Risk factors ++,↑↑ LDL, TC, tHCy, Obesity Disposed of as ordinary angina elsewhere We submitted him for Coronary Angiograph How are his coronaries ? What are the treatment options ?

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Treatment options Medical management PTCA + Stenting CABG Which is the right choice ? Why ? Web sites were provided to him He took an informed decision

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Follow up examination Clinical symptoms Weight Lipidemia Homocysteine Life style changes

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Present Status Now he is 59.5 Kg from 73 Kg No symptoms of IHD what so ever Continuing on

Atorvastatin 10 mg Folic Acid 5 mg Omega 3 fatty acids Cobalamine + Pyridoxine and Of course life style adaptations

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Now he is a happy manAnd a healthy young man

All his confidence is restored