A 63-year-old male with a history of CAD (Coronary Artery Disease) and two prior MIs (Myocardial Infarctions) presented with atypical chest pain and was admitted with a 100% LCx lesion unable to be stented. He was on medical management with Atenolol, Ace-I, and Aspirin (ECASA) 325 mg PO QD until the day of admission when he woke up with left arm and shoulder pain reminiscent of an old MI. Attempts at relief with nitroglycerin 1/150 (0.4 mg) 1 TAB SL q5min x 3 were unsuccessful, so he called EMS. In the ED, EKG and TnI were flat and he was started on heparin for unstable angina. Serial CKs were flat and he had no recurrence of chest pain in the hospital. He is to follow-up with Dr. Tollner with the possibility of ETT-MIBI as an outpatient. Discharge medications included Wellbutrin (Bupropion HCl) 200 mg PO QD, Colace (Docusate Sodium) 100 mg PO BID, FESO4 (Ferrous Sulfate) 300 mg PO BID, and Zocor (Simvastatin) 40 mg PO QHS. Additional instructions included taking the increased dose of Zestril 10 mg PO QD, making a follow-up appointment with Dr. Cyrus in the next week or two, and returning to the hospital if experiencing an increase in chest pain or shortness of breath at rest. The discharge condition was stable and he was discharged home with instructions to do an ETT-MIBI as an outpatient, check K and Cr within 1-2 weeks, and get a referral to GI and EGD as an outpatient.
Was the patient ever prescribed heparin
he was started on heparin for unstable angina.