Case Study - L

Patient L is a 56years Chinese female who presented with a 4 days history of exertional chest pains, which in the last 24 hours, became more severe with chest pains even at rest and with minimal exertion. She is a known hypertensive for the last 5 years, given atenolol by her GP. She smokes about 20 cigs daily for the last 30 years. On clinical examination, her BP was 140/90 mmHg, HR 80 / Min. Precordail examination was normal.The ECG is attached. Her (F) Lipid profile shows T.Cholesterol of 250 mMols/L, LDL-C 16 mMols/L, HDL-C of 0.9 mMols/L and TG of 1.5 mMols/L. Her (F) sugar was 5.7 mMols/L.


1. What is your clinical diagnosis?

2. What other biochemical test would you perform?

3. Would you order a stress ECG, or multi-slice CT scans?

4. How would you manage this patient?

5. Would you advise a coronary angiogram?