Tim goes to his family physician complaining of worsening angina, shortness of breath, and extreme fatigue….

Tim sees GP as condition worsens
Angina is shortness of breath and severe fatigue. Tim is 5’11”, 240″ tall
He is 68 years old and weighs 67. If you have a history of smoking, take one pack a day.
40 years on and now on the verge of type 2 diabetes. Tim has
No previous diagnosis of atherosclerosis.
Surgery to repair 2 blocked coronary arteries. Tim’s first year was 2008.
He went into cardiac arrest and was hospitalized for several months.
He also quit smoking.

Tim is retired and leads a relatively sedentary life. he
Takes his wife for a walk at least once a week, depending on how often she’s there.
Drag him out, but lately he’s worn out even that. he
Try to pay attention to what he eats – he avoids sweets most of the time,
However, he must eat a high-fat diet.
Beer every night. But he’s a little worried about his condition
He claims this causes chest pains and fatigue.
It feels “just right”.

Tim’s vitals at the doctor’s office are as follows:

HR 90 bpm. Slightly unstable 
 Blood pressure 140/80
 Breathing - mild shortness of breath, shallow 

Latest blood test findings:

 Total cholesterol - 240 mg/dL
 HDL - 31 mg/dL
 LDL - 140 mg/dL
 Fasting glucose - 100 mg/dL
 CRP slightly elevated 
 Mild hypernatremia 

Additional imaging showing neovascular occlusion in coronary arteries.
Tim is interested in another bypass surgery. This will be Tim’s second attempt at the program.
3 coronary arteries have been removed.

What surgical treatment would you recommend Tim for at this time?
Three reasons for your answer

Describe how each person improved Tim’s life.
cardiovascular health

Quit smoking

Healthy eating habits and reducing alcohol consumption are the keys to a healthy diet.

Exercise

Diabetes Management

What type of heart disease (left heart disease, right heart disease or biventricular disease?)?
Tim at risk for development? your choice.

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