Akanksha Williamover 4 years ago

Patient M., 47 years old, was admitted to the cardiology Department with complaints of pressing pain behind the sternum when walking fast, climbing 3-7 floors of stairs. The pain is relieved at rest for 1-2 minutes. From anamnesis: he got sick 2 weeks ago, when for the first time there was a pressing pain in the lower third of the sternum during a rapid ascent to the 4th floor, which passed at rest. He smokes for 20 years. General condition: the Condition is relatively satisfactory. The position is active. Appetite is increased. The skin is pale pink, there is no swelling. Above the lungs, respiration is vesicular. Borders of relative dullness of the heart: left-along the left mid-clavicular line, right-along the right edge of the sternum, upper-at the level of the III rib. The heart tones are clear and rhythmic. Blood pressure is 120/80 mm Hg heart rate-76 per minute. The stomach is painless. The size of the liver according to Kurlov: 9-8-7 cm. General analysis of blood and urine - without pathology. Cholesterol - 8.5 mmol/l; AST - 28ed/l; LDH - 320ed/l. ECG: sinus Rhythm, horizontal position of the electrical axis of the heart. Results of the load test (treadmill test): at a load of 100 W, there was a depression of the ST-T segment by 2 mm in leads V1 -V4. What is the diagnosis?