Shinitsu Ryuu writes:

        Patient Takahashi (T) who is a 39-year-old male has a high possibility of developing heart disease in the future. The reason is his lack of regular exercise, his heavy-smoking, and his being overworked, all of which are major known risk factors for CHD.

        Although Patient T is in this condition and exhibits many risk factors, he does not recognize his condition or these factors.

        I think I would help Patient T with advising him about the risk factors at first. And I would suggest to him that he should do regular exercise and decrease his amount of smoking. I think walking around every day is good. Of course no-smoking is the best option. But he might be stressed about it, and so decreasing the amount of smoking is O.K. to start. I think I can help Patient T with knowing the risk factors and getting rid of his pain according to a plan which I will detail below.

        Because Patient T does not think his condition is very serious, I will explain his condition using facts about his health. He has recently been diagnosed "hypertensive"(170/100mm Hg); he frequently experiences feelings of weakness and mild pain in the neck and upper chest areas; and clinical analyses indicate early atherosclerosis.

        In order to impress these facts on Patient T, I will refer to the problems in smoking cigarettes. Smoking is like putting his blood vessels into a time machine headed into the future. As people age, the walls of their arteries gradually thicken. Research published in the December 1994 issue of the AHA journal Circulation shows that cigarette smoking accelerates this process by more than a decade. By adding the equivalent of 10 years of aging to their arteries, smokers are increasing their risk of stroke and heart attack.

        In the short term, I will give him some medicine until he does not feel chest pain. And I will tell him to exercise regularly and decrease his smoking.

         

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