Reference no: EM133769194

Question

Mr. Singh, a 57-year-old schoolteacher, comes to the urgent care clinic complaining of difficulty breathing while running across the street yesterday. He had to stop at the median and loosen his tie and collar to catch his breath. He felt a bit lightheaded at the time. He denies chest pain, palpitations, nausea, vomiting, and diaphoresis. He has not had these symptoms in the past. It did not reoccur during the rest of the day, but he felt similar chest tightness and shortness of breath when he got up this morning, so he decided to come to the office. He is distraught and states, "I know what it is. My dad died of a heart attack when he was 53, and now it's my turn." While Mr. Singh is having an ECG performed, his wife takes you aside and tells you that he had been treated for hypertension, high cholesterol levels and diet-controlled diabetes but has refused all medication for the past year. He eats what he wants and does not get much exercise during the school year. According to his wife, Mr. Singh is about 23 kg overweight. She also tells you he smoked one pack per day for approximately.