Woman Diagnosed With Stable Angina: Chest Pain Should Not Be Ignored
Stable angina is a common cardiovascular condition that often signals underlying heart disease. This case involves a 58-year-old woman who experienced recurring chest pain during physical exertion. Her symptoms lasted for about 2 to 3 minutes and were quickly relieved by rest. After a thorough evaluation and diagnostic testing, she was diagnosed with stable angina. Due to the absence of surgical indications, she was treated with a combination of medications. After seven days of treatment, her symptoms improved significantly, and she expressed satisfaction with the results.
Key Information
Patient: Female, 58 years oldDiagnosis: Stable anginaHospital: The First Affiliated Hospital of Anhui Medical UniversityVisit Date: January 2022Treatment: Medication therapy including aspirin, atorvastatin, metoprolol succinate, isosorbide mononitrate, and amlodipine besylateDuration: 7-day inpatient treatment followed by 3 months of outpatient follow-upOutcome: Significant reduction in chest pain, no angina during physical activity, and positive overall response to treatment
Initial Consultation
In January 2022, the patient visited our hospital accompanied by her daughter. She reported a history of hypertension for over 10 years, during which she had been taking captopril for blood pressure control with minimal monitoring. About three months prior to the visit, she began experiencing chest pain while performing household chores, accompanied by fatigue and weakness. The discomfort would subside after a short rest. Similar symptoms occurred when she walked quickly with her family, causing chest pain, sweating, and fatigue. These symptoms lasted approximately 2 to 3 minutes and resolved quickly upon sitting down. At a local clinic, her blood pressure was recorded at 148/82 mmHg, and an ECG showed ST-T changes, leading to a suspected diagnosis of stable angina and hypertension. She was advised to seek hospitalization for further evaluation and treatment.
Treatment Process
Upon admission, the patient underwent a comprehensive physical examination, and no significant abnormal signs were found. Further diagnostic tests, including echocardiography, chest CT, blood tests, biochemical analysis, troponin, and cardiac enzyme levels, showed no remarkable abnormalities. Two specialized tests were recommended to confirm the diagnosis: an electrocardiographic exercise stress test and coronary angiography or CT angiography. Due to the patient's reluctance, the stress test was not performed. Instead, the family opted for coronary CT angiography, which revealed moderate stenosis in the left anterior descending artery. This confirmed the diagnosis of stable angina. Since no surgical intervention was indicated, the patient was started on a regimen of aspirin, atorvastatin, metoprolol succinate, isosorbide mononitrate, and later amlodipine besylate for blood pressure management. After seven days of treatment, her chest pain symptoms were notably reduced.
Outcome and Recovery
Under the guidance of a medical team, the patient experienced significant improvement after seven days of continuous medication. She was able to perform mild physical activities, such as brisk walking, without experiencing angina. Her blood pressure remained stable and within a safe range. She was discharged after a 7-day hospital stay. Before discharge, she was advised to continue her prescribed medications and schedule regular outpatient ECG follow-ups. She was also informed to seek immediate medical attention if she experienced an increase in the frequency or intensity of chest pain to avoid potential complications.
Post-Treatment Care and Lifestyle Adjustments
After treatment, the patient's discomfort gradually subsided, which was a positive outcome for both the patient and her family. Post-discharge instructions included maintaining a healthy lifestyle with a low-salt, low-fat diet, avoiding smoking and alcohol consumption, and regularly monitoring blood pressure to keep it below 130/80 mmHg. Once her condition stabilized, she was encouraged to engage in moderate physical activity. Exercise can help develop collateral circulation in the coronary arteries, improving blood supply to the heart muscle. However, she was advised to start slowly and avoid intense workouts that could trigger symptoms. Activities such as jogging, walking, and tai chi were recommended. Additionally, she was encouraged to maintain emotional stability, avoid extreme stress, and seek professional help when needed. Regular outpatient follow-ups were also emphasized to monitor for any signs of disease recurrence.
Clinical Insights on Stable Angina
Stable angina is a form of coronary artery disease typically triggered by physical exertion, as seen in this patient. Symptoms usually last a few minutes and are relieved by rest or nitrate medications such as nitroglycerin. The frequency, severity, and duration of episodes tend to remain consistent over several months, indicating a relatively stable state of coronary artery disease. In such cases, early medical management often provides effective symptom relief. Alongside treatment, it is crucial to manage risk factors for atherosclerosis, including hypertension, hyperlipidemia, and hyperglycemia. Addressing these factors can slow or even reverse disease progression and reduce the risk of acute events like myocardial infarction.