Stable there is reduced blood flow to the

Stable angina is caused when the heart muscle doesn’t receive enough
oxygen for it to function effectively (Tousoulis et al.,
and this can be due to factors such as atherosclerosis. Atherosclerosis (Ross, 1999) is caused when the arteries
of the heart become narrow and hard; due to factors like high cholesterol,
diabetes, smoking and high blood pressure. I believe that the patient has
stable angina because he has elevated cholesterol levels and mild hypertension,
both of which increase his risk factor of developing stable angina possibly
because of an underlying heart condition such as possible coronary artery


Another test could be a cardiac stress test, which would ensure that
there is no abnormal ST depression on the ECG. It would also help to see the patients’
overall fitness and any symptoms that might reduce the patients exercising
capacity, as well as the body’s heart rate and blood pressure reaction to exercise.

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Pneumothorax is commonly described as the build up of air in the
pleural space (D. et al.,
symptoms are often described as chest pain and shortness of breath, although teacher
does complain of chest tightness, he is not short of breath and so I would rule
this diagnosis out. Common gastro-oesophageal reflux disease (GERD) symptoms
can be heartburn and acid regurgitation (Badillo and Francis, 2014) because of reflux of the
contents of someone’s stomach. Therefore, I would rule out the possibility of
the teacher suffering from GERD because he doesn’t complain of heartburn or
acid reflux. Symptoms of angina can be described as chest pain or tightness, nausea,
tiredness, dizziness, and shortness of breath (Wilkins, 2014). Stable angina is a type of chest pain
that occurs when there is reduced blood flow to the heart (American Heart Association, 2016) and it is a predictable
pattern of chest pain because it can be tracked based on what you are doing, an
example might be that it only happens when you are exercising. The symptoms
that the teacher describes is of chest pain that occurs when he is exercising
and goes away when he stops. Some investigations that could be carried out to confirm
the diagnosis of angina could be; a blood test, chest x-ray and a resting ECG
to ensure that the patient doesn’t have any abnormal rhythms in their heart.


The patient is a 56-year-old male teacher and the symptoms that the
patient is complaining of are abnormal and all possible causes should be looked
at. Some possible causes of his symptoms are; Myocardial Infarction (MI),
anxiety, pulmonary embolism, pneumothorax, a strained chest muscle, gastro-oesophageal
reflux disease and angina. Symptoms of an MI can include chest pain, nausea,
shortness of breath, sweating, vomiting and fatigue, as well as other issues (Lu et al.,
These symptoms are not like the symptoms that the teacher is complaining of so
therefore I would rule an MI out. A pulmonary embolism can have symptoms that
are very non-specific to a possible diagnosis, but many patients that suffer
from a pulmonary embolism can suffer from symptoms such as sudden onset
dyspnea, syncope and chest pain(Miniati et al.,
A pulmonary embolism is usually only recognised if the patient is suspected of
developing it (Stein et al.,
The teacher does not mention all the symptoms of a pulmonary embolism.



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