In all the chapters the Case Studies represent situations similar to those that the medical assistant may encounter in daily practice. Students are encouraged to consider the case study as they read each chapter.

A 42-year-old man was referred to the cardiologist's office for an evaluation. The patient had recently started an exercise program for weight loss. For the last 3 weeks, following exercise, he had noticed radiating chest pain (angina pectoris) that stopped after rest. This condition had worsened in the last week. The cardiologist ordered a stress echocardiogram (a test that visualizes the heart during increasing stress). The echocardiogram results suggested that the patient had coronary artery disease. The patient was scheduled for a cardiac catheterization the next morning. It was noted in the patient's chart that he smoked two packs of cigarettes per day.

As you read this chapter, consider the following questions:

1. What symptoms suggest that this patient is suffering from coronary artery disease and not some other disorder?

2. Why is it important to test the heart under stress rather than obtaining a resting echocardiogram?

3. What lifestyle changes should this patient make to prevent future heart attacks?

4. Why is a cardiac catheterization needed in addition to the stress echocardiogram?

5. What are the treatment options for this patient?