Angina de novo in dyslipidemic patients, a clinical case

Medical Clinic No. 3, Department of Internal Medicine, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova, The 6th International Medical Congress for Students and Young Doctors, May 12-14, 2016Introduction: Angina is the most frequent pathology of coronary heart disease (CHD ) with a prevalence of between 0.76 to 15.1 % for men and 0.73 to 14.4 % for women. Angina de novo represents 31% of total patients with unstable Angine, predominantly affecting patients 52-71 years old with concomitant pathologies: hypertension ( HA) in 54.8 %, dyslipidemia (51.6 % ), diabetes ( DM ) in 29.0 % and smoking (51.6 % ). If we can reduce cholesterol levels by 25 % achieve a 50% reduction in the risk of acute myocardial infarction (AMI).Materials and Methods: Patient X., 64 years Diagnosis: Ischemic heart disease. Angina de novo ( from 2/5/2016 ). Hypertension gr. II, very high additional risk. IC II NYHA st. B ACC / AHA. Subcompensated type 2 diabetes. Dyslipidemia. Results. Accusations: constrictive chest pain triggered by minimal physical exertion, lasting 5 minutes ceding 1 nitroglycerin pill, inspiratory dyspnea, palpitations, congestion. The CBC: Hb-144g / l, Er.- 4.9x1012 / l, L.- 9,2x109 / l, ESR - 31mm / hour. Biochemistry: Urea - 10.7 mmol / l; creatinine - 120 mmol / l; uric acid - 470 mmol / l; glucose - 8.7 mmol / l; Cholesterol - 7.9 mmol / l, triglycerides - 3.60 mmol / L, K - 4.9mmol / l; N & lt; 146 mmol / l; Prothrombin - 90%, fibrinogen -3.5 g / l. The glycemic profile: 700- 9 mmol/l, 1300-10.8 mmol/l, 1700- 10,7 mmol/l; 2000- 9,4 mmol/l. ECG: sinus rhythm with 75 b / min. Heart Axis - horizontal deviation. Repolarization disorders in region of LV; EcoCG: Ao gracious walls ascend., V.Ao VM. LA moderate dilatation. Moderate concentric hypertrophy LV. Pump function of LV is preserved. LVEF-53%. Echo-Doppler CS: Vmax-N. Etc Not. VM gr.II. Etc Not. VT gr. II. Doppler intima media - 0.9 mm. Coronary angiography: LAD stenosis at the bifurcation of DIAI 40-50%. IMA: non-dominant. IMA stenosis in the segment average of 70%. Stenosis of the proximal RCA 70-90%. Conclusion: trivasculare atherosclerotic lesions, stenosis important IMA, RCA, LAD stenosis moderate. Treatment: Percutaneous Coronary Intervention on RCA, IMA, Atorvastatin 80 mg / day, Plavix 75 mg / day, Bisoprolol 5 mg / day Ramipril 5 mg / day, Diaprel 60 mg / day Conclusions: Patients with AP de novo in 76 % evolves AP stable and 24 % in AMI. AP de novo early detection, diagnosis by coronary angiography significant coronary lesions and facilitate prompt treatment prevent AMI development

The diagnostic significance of intima-media determination in patients with different ischemic cardiopathy variants

Departamentul Medicină Internă, USMF Nicolae Testemiţanu, IMSP SCM Sfânta Treime, Laboratorul hepatochirurgical, USMF Nicolae TestemiţanuThe process of systemic atherosclerosis has a long asymptomatic period corresponding with the occurrence of manifested cardiovascular disease, such as myocardial infarction or ischemic stroke, which results in the invalidity of the patient, lowering its quality of life, decreasing life expectancy and increasing spending in public health or death. The rise in the index of average thickness is intimate-the first observable sign of atherosclerosis, vascular damage from its substrate, being represented by fibrocelular hypertrophy and hyperplasia of smooth muscle cells in the media pressure

Particularities of intima-media determination in patients with different variants of ischemic heart disease (Literature review)

Departamentul Medicină Internă, USMF Nicolae Testemiţanu, IMSP SCM Sfânta Treime, Laboratorul hepato-chirurgical, USMF Nicolae TestemiţanuAtherosclerosis and its consequences are more common meet in ischemic heart disease and stroke, are and will continue to be present and in the next 20 years, the main cause of mortality of the population around the globe. Incidentally, the latter’s share in the structure of morbidity and general mortality has reached major odds and in the Republic of Moldova