0521779407-C03 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 20:54
Coronary Syndromes, Acute Coronavirus/Common Cold 413➣BP < 135/80
➣LDL < 100 (<70 preferred), use statin, escalate dose if necessary,
monitor for LFT elevation or rhabdomyolysis, consider adjuncts
(e.g., ezetimibe)
➣Tight glucose control in diabetic patients
➣Consider fibrate or niacin if HDL < 40 or TG >200
➣Prescribe appropriate exercise
complications and prognosis
Complications
■Recurrent admissions
■Ischemic cardiomyopathy, leading cause of clinical heart failure, can
progress to death or need for transplant.
■Dressler’s syndrome, uncommon without transmural infarct, peri-
cariditis usually∼6 weeks post infarction which is treated with
steroids or NSAIDS
■Depression: high-risk post-MI and worsens prognosis
■Arrhythmia:
➣Ventricular tachycardia, re-entry at scar or ischemic
➣Bundle branch block
➣Ventricular aneurysm
■Stroke
■Death: risk after NSTEMI > after STEMI
Prognosis
■Determined by risk stratification. Exercise time on treadmill and
LVEF are strong predictors.Coronavirus/Common Cold............................
CAROL A. GLASER, MD
history & physical
History
■Large RNA virus
■At least 2 antigenic groups of respiratory coronavirus
■Human only host
■Spread via resiratory secretions
■Young children have the highest attack rates.
■Incubation period 2–5 days
■Common cause of URI in adults/children