PJ’s current symptoms include worsening of chest pain from his stable angina; he has recently noticed that less physical exercise is needed to induce pain, and it generally occurs more frequently. The symptoms are consistent with unstable angina; normally, the latter diagnosis for stable angina patients is associated with the aggravation of pain, prolongation of periods for which it lasts, and its occurrence at rest (Giustino et al., 2015). In PJ’s case, chest pain does not occur at rest; however, the described symptoms may be early signs of unstable angina. The patient should be educated on available surgical methods of treating his condition; these include angioplasty and the placement of stents; in some cases, a more invasive procedure, such as a heart bypass, may be considered.
The ST-segment elevation is a sign of an MI; in fact, it is the first medical concern if the elevation is detected (Hanna & Glancy, 2015). However, it can be indicative of several other conditions, some of which may coexist with STEMI. These conditions include early repolarization, pericarditis, left ventricular hypertrophy, left bundle branch block, preexcitation, and hyperkalemia. An important consideration is the pattern of elevation, as this indicator can be different for different diagnoses.
The MI diagnosis can be further confirmed by a blood test; if the patient suffered a heart attack, the blood sample will contain certain cardiac markers (enzymes); however, their level does not rise immediately after a heart attack, which is why treatment for an MI should be provided before the blood test results confirm the diagnosis. According to Lilly (2012), pathophysiological responses to an MI include pain, diaphoresis, and loss of consciousness; these symptoms are due to the decrease of blood flow in the heart and subsequent damage to the cardiac muscle.
References
Giustino, G., Baber, U., Stefanini, G. G., Aquino, M., Stone, G. W., Sartori, S., … Mehran, R. (2015). Impact of clinical presentation (stable angina pectoris vs unstable angina pectoris or non–st-elevation myocardial infarction vs st-elevation myocardial infarction) on long-term outcomes in women undergoing percutaneous coronary intervention with drug-eluting stents. The American Journal of Cardiology, 116(6), 845-852. Web.
Hanna, E. B., & Glancy, D. L. (2015). ST-segment elevation: Differential diagnosis, caveats. Cleveland Clinic Journal of Medicine, 82(6), 373-384. Web.
Lilly, L. S. (Ed.). (2012). Pathophysiology of heart disease: A collaborative project of medical students and faculty (5th ed.). Baltimore, MD: Wolters Kluwer. Web.