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Assignment:
Mr. Skemp, a 76-year-old Asian American male patient, comes to your office today following a recent negative cardiac catheterization for angina chest pain. The patient has had four previous coronary stents, and it was determined that there was no blockage in the stents either. Prior to the catheterization, he was experiencing chest pressure, numbness in the left arm, and dyspnea that was brought on by exertion and exercise. He relates that the symptoms would dissipate soon after he rested. He would take sublingual nitrate often when he had the chest pain. He has a history of GERD, atrial fibrillation, has a pacemaker, and hyperlipidemia. He takes the following medications: Digoxin 0.25 mg o.d.
Metoprolol 25 mg bid ? Warfarin 7.5 mg o.d. ?Aspirin 81 mg o.d. ? Plavix 75 mg o.d. ? Losartan 25 mg o.d. ?Atorvastatin 20 mg o.d. ? Protonix 40 mg o.d. ? Mr. Skemp wants to know what treatment can be offered to him for his persistent chest discomfort. ? Describe how you would address the patient's needs and what may be included in your patient-centered treatment plan (including patient teaching).
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