A 45-year-old man developed constricting retrosternal pain that occurs during walks at the distance of 200 m. Objectively, heart rate is 80/min., BP is 160/90 mm Hg. During cardiopulmonary exercise test at 50 W there is a depression of S-T segment by 3 mm below the isoline in V3-V4. What is the provisional diagnosis?

Answer options

1. Exertional angina pectoris, functional class IV
2. Alcoholic myocardiodystrophy
3. Somatoform autonomic dysfunction, hypertension type
4. Exertional angina pectoris, functional class II
5. Exertional angina pectoris, functional class III

Explanation

A 45-year-old man developed constricting retrosternal pain that occurs during walks at the distance of 200 m. Objectively, heart rate is 80/min., BP is 160/90 mm Hg During cardiopulmonary exercise test at 50 W there is a depression of S-T segment by 3 mm below the isoline in V3-V4. What is the provisional diagnosis?C. Alcoholic myocardiodystrophy → Not indicatedE. Somatoform autonomic dysfunction, hypertension type → Not indicatedCanadian Cardiovascular Society grading scale is used for classification of angina severity, as follows: Class I – Angina only during strenuous or prolonged physical activity Class II – Slight limitation, with angina only during vigorous physical activity Class III – Symptoms with everyday living activities, i.e., moderate limitation Class IV – Inability to perform any activity without angina or angina at rest, i.e., severe limitation