79-Year-Old Woman Experiences Chest Tightness and Shortness of Breath – Turns Out to Be Angina
Angina can often present with symptoms like chest tightness, shortness of breath, and discomfort, especially in elderly patients. This case involves a 79-year-old woman who sought medical attention after experiencing persistent chest discomfort and breathing difficulties. After thorough evaluation, she was diagnosed with angina and successfully treated with medication. This article outlines her symptoms, diagnosis process, treatment plan, and recovery journey.
Case Overview
Patient: Female, 79 years oldDiagnosis: AnginaHospital: Third Xiangya Hospital, Central South UniversityVisit Date: June 2022Treatment: Beta-blockers and calcium channel blockersDuration: 7-day inpatient treatment, followed by outpatient follow-upOutcome: Symptoms resolved, stable vital signs, and successful discharge
Initial Consultation and Diagnosis
The patient reported experiencing chest tightness, pressure, and shortness of breath two days prior to her visit. These symptoms worsened with minimal physical activity and were accompanied by nausea. Despite resting, her symptoms did not improve, prompting her to seek medical care. Upon examination, an ECG revealed abnormal Q waves in certain leads, left axis deviation, and flattened T waves. A subsequent coronary angiography confirmed the presence of coronary artery disease, leading to a diagnosis of angina.
Treatment Plan and Medication
After explaining the diagnosis to the patient, a treatment plan was established using two key medications: atenolol and verapamil hydrochloride. Atenolol, a beta-blocker, was prescribed to reduce heart rate, lower blood pressure, and decrease myocardial oxygen demand. Verapamil, a calcium channel blocker, was added to further reduce cardiac workload and improve left ventricular diastolic function. The patient was educated on medication adherence and closely monitored throughout her hospital stay.
Progress and Recovery
By the first day of treatment, the patient showed early signs of improvement. She was alert, in good spirits, and reported a reduction in chest discomfort and nausea. By the third day, follow-up tests indicated further improvement. On the seventh day, her symptoms had completely resolved. Her heart rate was stable at 80 beats per minute, no pathological murmurs were detected, and there was no sign of lower limb edema. She was discharged with a positive prognosis.
Post-Discharge Recommendations
As the patient's condition improved, it was important to emphasize lifestyle adjustments and preventive measures:
- Maintain Emotional Stability: Stress and emotional fluctuations can strain the heart. Engaging in relaxing activities like painting or singing is encouraged.
- Monitor Symptoms: If chest discomfort, nausea, or shortness of breath returns, prompt medical evaluation is advised.
- Regular Health Check-Ups: Given her age, routine medical exams are essential for early detection of potential health issues.
Clinical Insights and Final Thoughts
This case highlights the importance of timely diagnosis and appropriate treatment in managing angina, especially in older adults. The patient's early presentation and adherence to prescribed therapy contributed significantly to her favorable outcome. It also serves as a reminder that self-medication should be avoided, as improper drug use can lead to complications. With proper care and follow-up, patients with angina can experience symptom relief and improved quality of life.