Case 28

Published on 02/03/2015 by admin

Filed under Internal Medicine

Last modified 02/03/2015

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Case 28

The patient is an 81-year-old male with type 2 diabetes, hypertension, hyperlipidemia, and myocardial infarction 30 years earlier. He did not consent to cardiac catheterization and never underwent catheterization or revascularization. He is currently doing well and is physically active with normal exercise tolerance. He was referred for a routine stress/rest 99mTc-sestamibi perfusion imaging study.

Medications: pravastatin, nadolol, lisinopril, nifedipine, aspirin, and metformin.

Pharmacologic stress perfusion imaging using 5-minute adenosine infusion was performed, and the following changes were noted: heart rate rose from 60 to 70 beats/min and blood pressure dropped from 130/90 to 125/61. The patient reported no chest pain.

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