Question

A 45-year-old man is evaluated for a 6-month history of palpitations, easy fatigability, and chest pain on exertion. He does not smoke or consume alcohol; he has no significant past medical history. His body weight has remained stable. He has spent the last 2 years traveling the world. His wife says that he eats ""unhealthily."" He is a strict vegan, consumes a lot of snacks, and has never taken any vitamin supplements. Examination shows a 5'7"" male with a BMI of 19. His BP is 130/70 and pulse 90/min; his temperature is 98.4°F. Conjunctival pallor is present. Auscultation shows a grade 2/6 murmur ejection systolic murmur heard all over the precordium. Lab investigations are sent and are given below:

Hb: 8.8 g/dL
WBC: 6000/mm3
MCV: 72
Ferritin: low
TIBC: elevated
Stool occult blood: negative
ESR: 8 mm/hour
TSH: normal

What is the most appropriate medical therapy?

Answer 1

The most appropriate medical therapy for the patient would be iron supplementation.

Step-by-step explanation:

The most appropriate medical therapy for the 45-year-old man with palpitations, easy fatigability, and chest pain on exertion would depend on the underlying cause of his symptoms and his lab results. Based on the provided information, the patient has a low hemoglobin level (Hb) of 8.8 g/dL, which indicates anemia. In addition, his ferritin level is low and his transferrin iron-binding capacity (TIBC) is elevated, suggesting iron deficiency anemia. Therefore, the most appropriate medical therapy for this patient would be iron supplementation.