What is epidemiology of coronary artery disease

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Ruth Olson, a 73-year-old female presented to the emergency department with a recent (4-hour) history of severe chest pain radiating to her left arm. She was suspected of having had a "heart attack." Coronary angiography revealed complete occlusion of the left anterior descending branch about 2 cm from its origin. She was given a therapeutic dose of recombinant human tissue plasminogen activator (tPA). This treatment restored coronary artery blood flow, and her chest pain improved. Simultaneously, she was started on one tablet of aspirin per day.

Seven days later, she noted swelling of both legs and feet and was found to have pitting edema of the legs; her liver was enlarged, and her neck veins (jugular) appeared full. She was given diuretics and asked to consume a salt-restricted diet. Because of considerable weakness, she remained in bed most of the time.

A few days later, she developed sudden pain in the lower right part of her chest, aggravated by taking a deep breath. Physical examination revealed that her left leg had more swelling than the right. X-ray of her chest showed a faint shadow in the peripheral part of the lower lobe of the right lung. Intravenous heparin was started.

What is the epidemiology of coronary artery disease in the United States? (CDC; WHO; American Heart Association, and other sources) What are the clinical settings in which venous thrombosis of leg veins occurs? What is the most feared consequence? What is the Primary Diagnosis? What are two possible differential diagnoses? What is the likely outcome of this case?

Reference no: EM133657061

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