Medical Case Study 19 Annie's Heartache
4
Cardiovascular disorders
CASE STUDY 19 Annie’s heartache
Learning outcomes
On completion of this case study, you will be able to:
• describe the physiological characteristics of the coronary circulation;
• outline the autonomic control of the heart and the mechanisms which control coronary blood flow;
• review the causes of and possible treatments for angina;
• describe the mechanisms of action of the following anti-anginal drugs: nitrates, beta-adrenoceptor antagonists and calcium channel blockers.
Part 1
Annie is an elderly lady who lives with a one-eyed cat and a budgie. She is rather overweight and sometimes out of breath. Annie is very involved in the community, helps with many voluntary activities organized by …show more content…
She reports that the pain in her chest is now coming more frequently. She has given up her voluntary work as she cannot now manage to walk up the hill and climb the stairs to the Community Volunteers’ office. She also reports that she doesn’t obtain adequate pain relief from the GTN prescribed. The doctor notes the worsening of her symptoms and suspects that she might not be obtaining pain relief from GTN because she is swallowing the tablets.
He decides to prescribe her an alternative anti-anginal agent.
Q8 Explain the types and common causes of angina.
Q9 Why might swallowing the GTN tablets limit Annie’s pain relief?
Q10 Would the beta-adrenoceptor (β-adrenoceptor) antagonist propranolol be suitable medication for Annie? Give reasons for your answer.
Q11 What is the pharmacological action of propranolol?
Q12 How can angina be distinguished from myocardial infarction?
Q13 A third type of agent available for the treatment of angina is a calcium channel blocker. Explain the pharmacological action of calcium channel blockers.
CASE STUDY 20 THE EXECUTIVE’S MEDICAL CHECK-UP
39
CASE STUDY 20 The executive’s medical check-up
Learning outcomes
On completion of this case study, you will be able
Cardiovascular disorders
CASE STUDY 19 Annie’s heartache
Learning outcomes
On completion of this case study, you will be able to:
• describe the physiological characteristics of the coronary circulation;
• outline the autonomic control of the heart and the mechanisms which control coronary blood flow;
• review the causes of and possible treatments for angina;
• describe the mechanisms of action of the following anti-anginal drugs: nitrates, beta-adrenoceptor antagonists and calcium channel blockers.
Part 1
Annie is an elderly lady who lives with a one-eyed cat and a budgie. She is rather overweight and sometimes out of breath. Annie is very involved in the community, helps with many voluntary activities organized by …show more content…
She reports that the pain in her chest is now coming more frequently. She has given up her voluntary work as she cannot now manage to walk up the hill and climb the stairs to the Community Volunteers’ office. She also reports that she doesn’t obtain adequate pain relief from the GTN prescribed. The doctor notes the worsening of her symptoms and suspects that she might not be obtaining pain relief from GTN because she is swallowing the tablets.
He decides to prescribe her an alternative anti-anginal agent.
Q8 Explain the types and common causes of angina.
Q9 Why might swallowing the GTN tablets limit Annie’s pain relief?
Q10 Would the beta-adrenoceptor (β-adrenoceptor) antagonist propranolol be suitable medication for Annie? Give reasons for your answer.
Q11 What is the pharmacological action of propranolol?
Q12 How can angina be distinguished from myocardial infarction?
Q13 A third type of agent available for the treatment of angina is a calcium channel blocker. Explain the pharmacological action of calcium channel blockers.
CASE STUDY 20 THE EXECUTIVE’S MEDICAL CHECK-UP
39
CASE STUDY 20 The executive’s medical check-up
Learning outcomes
On completion of this case study, you will be able