72-Year-Old Man Experiences Frequent Chest Discomfort – Angina Pectoris Was the Culprit!
It's not uncommon for individuals to experience chest discomfort from time to time, but when symptoms persist, it may indicate a more serious underlying condition. A 72-year-old male recently found himself facing this exact situation. Six days prior to his hospital visit, he began experiencing episodes of chest tightness and shortness of breath without any obvious cause. The discomfort was centered in the chest area and varied in intensity throughout the day. Physical activity seemed to worsen the symptoms, though he did not experience nausea, vomiting, coughing, palpitations, or dizziness. Due to the persistent nature of the discomfort, he sought medical attention at a hospital.
Case Overview
Patient: Male, 72 years oldDiagnosis: Angina PectorisHospital: Third Xiangya Hospital, Central South UniversityVisit Date: June 2022Treatment: Medication therapy using Nitroglycerin tablets and Propranolol Hydrochloride tabletsDuration: 11 days of in-hospital treatmentOutcome: Symptoms of chest tightness and breathlessness improved significantly
Initial Consultation
Upon first meeting the patient, he described a sudden onset of chest tightness and shortness of breath six days earlier. The sensation was described as a pressure-like discomfort in the chest, varying in intensity and worsening with physical exertion. He also reported occasional radiation of the discomfort to the left shoulder and upper limb. No self-medication had been attempted at home. Further inquiry revealed a past medical history of bronchitis and cervical spondylosis. Upon physical examination, coarse breath sounds were noted on auscultation, but no signs of lower limb edema, pericardial friction rub, or pathological heart murmurs were detected. An ECG revealed sinus rhythm, left ventricular high voltage, ST-segment depression in certain leads, and abnormal T waves. Coronary angiography confirmed angina pectoris, prompting hospital admission.
Treatment Plan
Medication Therapy
After confirming the diagnosis, I discussed the treatment options with the patient and recommended prompt pharmacological intervention to manage the condition and prevent further complications. He was prescribed Nitroglycerin tablets, which help dilate blood vessels and reduce myocardial oxygen demand, effectively alleviating angina symptoms. Additionally, he was instructed to take Propranolol Hydrochloride tablets, which help reduce myocardial ischemia and improve symptoms of chest tightness and dyspnea.
Progress and Recovery
By the first day of treatment, the patient reported a noticeable reduction in the intensity of his chest discomfort compared to when he was admitted. On the 11th day of hospitalization, during routine rounds, he indicated that his symptoms had largely subsided. Vital signs were stable: temperature at 36.6°C and blood pressure at 121/76 mmHg. Lung auscultation revealed clear breath sounds, and there was no evidence of pericardial friction rub. Following a successful treatment course, the patient was discharged with no further complications.
Post-Discharge Recommendations
Diet and Lifestyle Adjustments
While I was pleased to see the patient recover well, I emphasized the importance of post-discharge care to prevent recurrence:
- Maintain a balanced and light diet rich in fruits, vegetables, legumes, and lean proteins. Avoid spicy, fatty, or overly processed foods that may hinder recovery.
- Stay warm and engage in light physical activities such as walking or tai chi to support cardiovascular health and overall well-being.
- Continue prescribed medications as directed and seek immediate medical attention if any discomfort arises.
Clinical Insights
Angina pectoris is a condition that should not be taken lightly. Left untreated, it can significantly impact one's quality of life and even pose life-threatening risks. Early diagnosis and appropriate intervention are crucial in managing the condition effectively. This case highlights the importance of timely medical attention, as prompt treatment helped stabilize the patient's condition and prevent further complications. If you or a loved one experiences persistent chest discomfort, don't delay in consulting a healthcare professional for a comprehensive evaluation.