Case Fridays - Searching your heart for the answer

MajoraCarterGroup via Flickr

This week's case comes from @DrVes's  http://clinicalcases.org/. It is another cardiovascular case and highlights the importance of appropriately evaluating risk factors. It is more about the thought process, rather than a typical exam style case presentation.

Presenting Complaint
An 81 year-old African American female is admitting to hospital with worsening abdominal pain over the last 2-3 days.


There is no chest pain or dsyponea (shortness of breath), however she complains of  nausea and vomiting.

Past Medical History
On examination of the patient's history it appears that she has a history of hypertension, Type 2 Diabetes mellitus (formerly NIDDM), coronary artery disease status post myocardial infarction (CAD S/P MI) 5 years ago and chronic abdominal pain for the last 2 years without a clear reason.

Physical Examination
38.8 C
RR: 16/min
78 bpm
210/100 mm/Hg

Abdomen: RLQ tenderness, no rebound, soft, +BS.
The rest of the examination was not remarkable.

For the remainder of the case click here.

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