Stable Angina Laboratory and Diagnostics Tests

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* Primary Diagnosis and ICD-10 code:
Stable Angina, I20.9
* Additional laboratory and diagnostic tests:
The patient should be evaluated holistically since he has several risk factors. Aside from the tests mentioned in iHuman, the following are the additional laboratory and diagnostic tests that the patient should undergo:
1 Chest x-ray
This reflects the consequences of ischemic such as cardiac hypertrophy/enlargement, which will show as the displacement of cardiac shadow, signs of HF, or ventricular aneurysm. Also, the patient is a smoker. This can also be used to check if any lung abnormalities need to be addressed (Jameson, 2018).
2 High sensitivity C-reactive protein (CRP)
Jameson (2018) states that an increase in CRP (0 to 3 mg/dL) is an independent risk factor for ischemic heart disease. Furthermore, this is used in categorizing the patient based on the traditional risk factors.
3 Doppler and Ultrasound (Duplex) Imaging of the lower extremities
The patient showed signs of peripheral arterial disease, as evidenced by the decreased pulsations in the bilateral femoral, posterior tibial, and dorsalis pedis arteries. Doppler and ultrasound imaging is a non-invasive test that illustrates the arterial walls in the lower extremities using sound waves. Also, it measures the blood flow inside the arteries and detects blockage that prevents the normal blood flow (Tehan et al., 2018).
4 Coronary angiography
This diagnostic tool helps visualize the coronary arteries and the particular location of the blockage due to an atheromatous plaque formation (Lee et al., 2018).
* Consults
1 Referral to a cardiologist is vital to have proper management of the case.
2 Referral to physical therapy is necessary to improve the overall cardiorespiratory function.
3 Referral to a nutritionist and dietitian is necessary to monitor the diet of the patient because he has high cholesterol, LDL, triacylglycerol, and low HDL.
* Therapeutic modalities
1 Pharmacologic management:
1 Angiotensin-converting enzyme inhibitor (Captopril). Take one tab of captopril 25mg orally on an empty stomach once daily for two weeks.
This is recommended for Stage II hypertension, like the patient's case. It blocks the conversion of angiotensin I to II, thereby preventing vasoconstriction of the vessels. Consequently, it decreases the total peripheral resistance, decreasing blood pressure (Jameson, 2018).
2 Statin (Atorvastatin). Take one tab of Atorvastatin 40mg orally, once daily for two weeks.
Although the patient may not tolerate this well, his cholesterol level is already high. Hence, it must be controlled using medications. Statin therapy is recommended to reduce the total cholesterol and lipid levels of the patient. LDL must be reduced. Statins also reduce the cholesterol deposits in the lower extremities, thereby improving the blood flow in the area (Jameson, 2018).
3 Cilostazol. Take one tab of cilostazol 100mg orally, twice daily, taken at least 1...