1. EACH PATIENT - AN OPEN BOOK Interesting Clinical Cases
Dr. R.V.S.N.Sarma., M.D., M.Sc., (Canada)
5 Jayanagar, Tiruvallur
Mobile
Visit us at :

2. 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 ?

5. 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 ?

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

10. Follow up examination Clinical symptoms Weight Lipidemia Homocysteine
Life style changes

14. 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

15. All his confidence is restored
Now he is a happy man
And a healthy young man
All his confidence is restored