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Case Conclusion: Follow-Up in Primary Care
The patient, returns to your primary care clinic for a follow-up appointment 6 weeks after discharge from hospital for a confirmed inferior STEMI. He underwent successful primary Percutaneous Coronary Intervention (PCI) and was discharged on the following medications:
Aspirin: 75mg once daily (lifelong).
Clopidogrel: 75mg once daily for 12 months post-MI.
Ramipril: 5mg once daily.
Bisoprolol: 2.5mg once daily.
Atorvastatin: 80mg once daily.
GTN spray (glyceryl trinitrate): for symptomatic relief of angina, if needed.
Lifestyle Advice: Encourage smoking cessation, if applicable. Promote a Mediterranean-style diet and regular physical activity (e.g., cardiac rehabilitation exercises).
Monitoring: Schedule regular blood pressure, lipid profile, and renal function checks to ensure medications are optimised. Assess for adherence to the treatment plan and address any side effects.
Red Flag Symptoms: Advise the patient to seek immediate help if they experience chest pain, breathlessness, or signs of heart failure (e.g., ankle swelling).
Congratulations!
Well done for completing this case scenario. You’ve successfully identified a STEMI in a primary care setting, ensured urgent referral and management, and followed up with appropriate secondary prevention measures. Your actions have significantly improved this patient’s prognosis and quality of life.
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