David, a 54-year-old accountant, is married with 2 adult children.  David had always led a busy but active life. Recently, he started experiencing what he thought was severe heartburn. The discomfort was new and came on when he walked between meetings with clients which were held in different buildings in the CBD.  He went to his local pharmacy seeking Nexium, hoping to find relief for what he assumed was worsening reflux. The pharmacist noticed that David seemed quite distressed and observed that he described the pain as tight and heavy, especially when climbing stairs or walking briskly up hills, and was relieved when he rested. Concerned that his symptoms might be more than just acid reflux, Jane gently suggested that he see his GP for a thorough evaluation.

David took his pharmacist’s advice and visited his GP. During the consultation, David explained that the pain often began with exertion and would ease after he rested. Dr Patel noted David’s history of poorly controlled hypertension, dyslipidaemia (diet managed), and erectile dysfunction, which could complicate his current symptoms. She suspected that David might be experiencing angina, a condition where the heart doesn’t receive enough blood and oxygen, leading to chest pain.

To confirm the diagnosis, his GP recommended a series of tests, including an ECG and stress test. The results indicated that David indeed had angina. To further investigate the condition and determine the extent of any coronary artery disease, David’s GP also referred David to the local cardiologist for an angiogram.

In the meantime, to manage his angina symptoms, Dr. Patel prescribed a short-acting nitrate spray (Nitrolingual), which would help relieve the chest pain when David experienced it. Additionally, to address the underlying causes and prevent worsening of his condition, she prescribed a beta blocker (metoprolol) to help reduce the workload on his heart and atorvastatin, a medication to lower his cholesterol levels.

Given David’s history of hypertension, Dr. Patel also reviewed his current blood pressure management and adjusted his treatment plan to better control his hypertension.

David was relieved to have a clearer understanding of his condition and was grateful for his care team’s vigilance. With a comprehensive treatment plan, the upcoming angiogram, and a new approach to managing his hypertension, he felt hopeful about managing his health and resuming his active lifestyle safely.