HART& VATEN 2 2025-2026
Ischemischhartlijden-casus1..................................................................................................................13
Instabieleangor&non-ST-elevatieMI(NSTEMI)......................................................................................17
Ischemischhartlijden-casus2..................................................................................................................28
ST-elevatieMI(STEMI).................................................................................................................................31
ComplicatiesSTEMI.................................................................................................................................38
Aritmieën............................................................................................................................................39
Cardiogeneshock..............................................................................................................................39
Myocardruptuur..................................................................................................................................40
Rechterventrikelinfarct.......................................................................................................................41
Pericarditis..........................................................................................................................................42
Post-infarct...............................................................................................................................................42
Stabielischemischhartlijden-diagnostiek..............................................................................................45
Myocardialeischemie...............................................................................................................................45
Stabieleangina........................................................................................................................................47
Ischemischesyndromen..........................................................................................................................49
Variantangina=Prinzmetal’sangina.................................................................................................49
Microvasculaireangina.......................................................................................................................50
Silentieuzeischemie...........................................................................................................................50
Ischemischhartfalen..........................................................................................................................51
Stabielischemischhartlijden-beleid........................................................................................................56
BehandelingCIHL....................................................................................................................................56
Anti-anginosa.....................................................................................................................................56
Bloedplaatjes-aggregatieremmers.....................................................................................................59
Anticoagulantia...................................................................................................................................60
Lipidenverlagendemiddelen..............................................................................................................60
Coronairerevascularisatie..................................................................................................................62
Hart-longmachine..............................................................................................................................63
Ischemischhartlijden-casuïstiek..............................................................................................................64
Cardiovasculairepreventie.........................................................................................................................70
Risicofactoren..........................................................................................................................................70
Roken.................................................................................................................................................71
Cholesterol.........................................................................................................................................73
Gewicht..............................................................................................................................................75
Lichaamsbeweging.............................................................................................................................77
Bloeddruk...........................................................................................................................................77
Cardiovasculairepreventie-casussen......................................................................................................80
Cardiomyopathieën......................................................................................................................................88
Cardiomyopathieën..................................................................................................................................88
Gedilateerdecardiomyopathie(DCM)......................................................................................................89
Hypertrofecardiomyopathie(HCM)ofhypertrofieobstructievecardiomyopathie(HOCM).....................92
Restrictievecardiomyopathie...................................................................................................................98
AritmogeneRV-cardiomyopathie(ARVC)..............................................................................................101
Aritmogenecardiomyopathie(ACM)......................................................................................................102
Non-compactiecardiomyopathie(LVNC)...............................................................................................103
Takotsubocardiomyopathie...................................................................................................................104
Hartfalen......................................................................................................................................................105
1
, asus-eenpatiëntmethartfalen.............................................................................................................117
C
Pericardialeaandoeningen.......................................................................................................................122
Pericard..................................................................................................................................................122
Acutepericarditis....................................................................................................................................122
Pericard-effusie......................................................................................................................................125
Tamponade............................................................................................................................................127
Pericarditisconstrictiva..........................................................................................................................129
Endocarditis...............................................................................................................................................132
Congenitalehartaandoeningen(bijvolwassenen).................................................................................138
Aangeborenhartafwijkingen...................................................................................................................140
Acyanotischehartafwijkingen.................................................................................................................141
Atriumseptumdefect(ASD).............................................................................................................141
Ventrikelseptumdefect(VSD).........................................................................................................143
Patenteductusarteriosus(PDA)......................................................................................................144
Congenitaleaortaklepstenose.........................................................................................................145
Congenitalepulmonalisklepstenose................................................................................................146
Coarctatioaortae..............................................................................................................................147
Cyanotischehartafwijkingen..................................................................................................................149
Tetralogievanfallot(TOF)................................................................................................................149
Transpositievandegrotevaten.......................................................................................................150
Atrio-venticulariseptumdefect(AVSD)............................................................................................151
Eisenmengersyndroom...................................................................................................................152
Pulmonalehypertensie..............................................................................................................................154
Oorzaken................................................................................................................................................155
PHdoorlinkerhartlijden...................................................................................................................156
PHdoorlonglijdenen/ofhypoxemie.................................................................................................156
A.pulmonalisobstructie...................................................................................................................156
Onduidelijkmechanisme..................................................................................................................156
Pulmonalearteriëlehypertensie(PAH)............................................................................................156
Screening...............................................................................................................................................158
Klachten&klinischebevindingen...........................................................................................................159
Evaluatie&prognose.............................................................................................................................160
Diagnostiek............................................................................................................................................160
Prognose................................................................................................................................................166
Behandeling(grotelijnenkennen!).......................................................................................................167
Hypertensiefhart-envaatlijden................................................................................................................171
Oorzakenvanhypertensie.....................................................................................................................175
Essentiële/primairehypertensie.....................................................................................................176
Metaboolsyndroom..........................................................................................................................177
Diagnostiekvanhypertensie..................................................................................................................178
1.BevestigingvanverhoogdeBD/hypertensie..............................................................................178
2.Evaluatieglobaalcardiovasculairrisico........................................................................................181
3.Secundaireoorzakennagaan......................................................................................................184
Aanpakvanhypertensie.........................................................................................................................190
Niet-medicamenteus-levensstijl......................................................................................................191
Medicamenteus................................................................................................................................192
Combinatietherapie..........................................................................................................................197
Interventioneel..................................................................................................................................199
Therapeutischeaanpakinspecifiekecondities......................................................................................199
2
, arttonen&geruis.....................................................................................................................................207
H
Klepaandoeningen-mitraalkleplijden.....................................................................................................210
Mitraalstenose........................................................................................................................................210
Mitralis-insufficiëntie(MI)........................................................................................................................214
Mitralisklepprolaps=ziektevanBarlow.................................................................................................219
Klepaandoeningen-aortakleplijden........................................................................................................221
Aortaklepstenose...................................................................................................................................221
Aortaklep-insufficiëntie(AI)....................................................................................................................227
Tricuspidkleplijden..................................................................................................................................231
Pulmonaliskleplijden...............................................................................................................................232
Klepaandoeningen-casus........................................................................................................................233
Klepaandoeningen-cardialeheelkunde.................................................................................................237
Aortaklepstenose(AS)...........................................................................................................................237
Aortaklepstenose(AS)-chirurgie..........................................................................................................238
Mitralisklepinsufficiëntie(MI)..................................................................................................................247
Mitralisklepinsufficiëntie(MI)-chirurgie.................................................................................................250
Ventrikelseptumruptuur(VSR)...............................................................................................................254
ECMO,harttransplantatie&VAD’s...........................................................................................................256
Cardialepathologie....................................................................................................................................273
Pathologievandebloedvaten................................................................................................................273
Arteriosclerose.................................................................................................................................273
Atherosclerose.................................................................................................................................273
Vasculitis..........................................................................................................................................275
Ischemischehartaandoeningen.............................................................................................................275
Myocarditis.............................................................................................................................................277
Pericarditis.............................................................................................................................................277
Trofischestoornissen.............................................................................................................................278
Hypertrofecardiomyopathie.............................................................................................................278
Stapelingsziekten.............................................................................................................................278
Abnormaalinterstitium......................................................................................................................279
Klepaandoeningen.................................................................................................................................279
Infectieuzeendocarditis....................................................................................................................279
Ritmestoornissen.......................................................................................................................................281
Bradycardie-mechanismen..................................................................................................................282
Sinusknoopziekten...........................................................................................................................282
AV-geleidingsstoornissen.................................................................................................................284
Bundeltakblok...................................................................................................................................285
Bradycardie-behandeling.....................................................................................................................286
Tachy-aritmieën-mechanismen............................................................................................................287
Tachy-aritmieën-focalemechanismen..................................................................................................287
Automaticiteit....................................................................................................................................288
Getriggerdeactiviteit........................................................................................................................290
Tachy-aritmieën-reentrycircuits/cirkel-activiteit....................................................................................292
Cirkelritmestoornissen......................................................................................................................292
Prikkelbaarheid.................................................................................................................................293
Tachy-aritmieën-cirkelritmestoornissen................................................................................................293
Kentbundel......................................................................................................................................293
Wolff-Parkinson-Whitesyndrome(WPW)........................................................................................294
Tachyaritmieën-ventriculair..................................................................................................................296
3
, entrikeltachycardie(VT)................................................................................................................296
V
Ventrikelfibrillatie(VF)......................................................................................................................298
Tachyaritmieën-supraventriculair.........................................................................................................299
AV-nodalereentrytachycardie(AVNRT)..........................................................................................299
Ectopischeatrialetachycardie(EAT)...............................................................................................300
Multifocaleatrialetachycardie(MAT)...............................................................................................301
Voorkamerflutter...............................................................................................................................301
Voorkamerfibrillatie(VKF=AF)........................................................................................................302
Tachyaritmieën-behandeling................................................................................................................306
PSVT-behandeling...............................................................................................................................309
EAT&MAT-behandeling......................................................................................................................310
VKF-behandeling.................................................................................................................................310
Flutter-behandeling..............................................................................................................................318
PolymorfeVT(PMVT)-behandeling.....................................................................................................318
Regelmatigenbredecomplexen-behandeling.....................................................................................319
Casus-patiëntmetpalpitaties.................................................................................................................321
Casus-patiëntmetrecurrentepalpitaties..............................................................................................325
Casus-Patiëntmetplotsedood..............................................................................................................336
Oorzakenvanplotsedood.....................................................................................................................339
Commotiocordis..............................................................................................................................340
Coronairarterieanomalieën..............................................................................................................340
Anderecardiovasculaireaandoeningen...........................................................................................340
AritmogeneRVcardiomyopathie(ACMP)........................................................................................341
Hypertrofecardiomyopathie.............................................................................................................341
Long-QTsyndromen(LQT)..............................................................................................................342
PreventievanSCD.................................................................................................................................342
Syncope......................................................................................................................................................344
Vasovagalesyncope=neurocardiogenesyncope=apppelflauwte......................................................347
Orthostatischehypotensie......................................................................................................................351
Rijgeschiktheid...........................................................................................................................................353
Cardialebeeldvorming-RXthorax..........................................................................................................355
Cardialebeeldvorming-nucleairecardiologie.......................................................................................363
Invivoonderzoekenincardiologie.........................................................................................................363
Myocardperfusiescintigrafie:(gated)SPECT.........................................................................................363
Hartfunctiescintigrafie:GBPS.................................................................................................................367
Positronemissietomografie(PET)........................................................................................................368
Cardialebeeldvorming..............................................................................................................................371
Echocardiografie....................................................................................................................................371
CardialeMRI..........................................................................................................................................377
CardialeCT............................................................................................................................................380
Hartonderzoek............................................................................................................................................382
4
, Ischemisch hartlijden - casus 1
CASUS
nonkel Frans
● een gezellig nazomer familie-BBQ in de Ardennen
● iedereen eet Bourgondisch, de sfeer zit goed
● een half uurtje na de BBQ
○ nonkel Frans voelt zich onwel
○ hij vermeldt pijn achter het borstbeen: "Ik heb het zuur. Ik heb weeral teveel gegeten”
○ jij bent de toekomstige dokter van de familie, dus zegt Nonkel Frans tegen jou: "Hé, wat doe
ik hieraan?"
differentieel diagnose
● indigestie met vagale symptomatologie
● slokdarm spasmen: krampachtige pijn, niet uitstralend naar arm of tanden
● pericarditis
● angina pectoris
● aorta ruptuur
● pulmonair probleem: infectie, embool, pneumothorax…
● galkoliek
anamnese
● eerder doorgemaakt? → ja, elke keer dat hij teveel eet
● klacht
○ waar zit de pijn?
○ uitstraling?
■ naar linker bovenarm tot ulnaire zijde van hand, hals, beide kaken, tandpijn →
ischemisch hartlijden
■ naar rug → aortadissectie
■ naar epigastrium → indigestie
■ naar rechter hypochonder → galkolieken, cholecystitis
■ naar laterale, basale thorax → pleurale irritatie door longembolen of pneumonie
○ type pijn?
■ scherp, stekend, ademhalingsgebonden & houdingsgebonden (beter bij voorover
buigen): pericarditis
○ verloop, progressief karakter?
■ voorbije weken abnormaal kort van adem bij minste inspanning → instabiele angor
■ geen pijn
● medicatie
○ Perindopril 5 mg/dag → ACE-inhibitoren (bloeddrukverlager)
○ Metformine 2x 850 mg/dag → antidiabeticum
○ Simvastatine 40 mg/dag → statine (cholesterol-verlager)
● CV-risicofactoren
○ leeftijd: 66 jaar
○ obees (BMI 31)
○ hypertensie
○ diabetes mellitus
○ hypercholesterolemie
○ roker tot 52ste
⇒ obv karakter van de klacht + CV-risicofactoren: angina pectoris
5
Ischemischhartlijden-casus1..................................................................................................................13
Instabieleangor&non-ST-elevatieMI(NSTEMI)......................................................................................17
Ischemischhartlijden-casus2..................................................................................................................28
ST-elevatieMI(STEMI).................................................................................................................................31
ComplicatiesSTEMI.................................................................................................................................38
Aritmieën............................................................................................................................................39
Cardiogeneshock..............................................................................................................................39
Myocardruptuur..................................................................................................................................40
Rechterventrikelinfarct.......................................................................................................................41
Pericarditis..........................................................................................................................................42
Post-infarct...............................................................................................................................................42
Stabielischemischhartlijden-diagnostiek..............................................................................................45
Myocardialeischemie...............................................................................................................................45
Stabieleangina........................................................................................................................................47
Ischemischesyndromen..........................................................................................................................49
Variantangina=Prinzmetal’sangina.................................................................................................49
Microvasculaireangina.......................................................................................................................50
Silentieuzeischemie...........................................................................................................................50
Ischemischhartfalen..........................................................................................................................51
Stabielischemischhartlijden-beleid........................................................................................................56
BehandelingCIHL....................................................................................................................................56
Anti-anginosa.....................................................................................................................................56
Bloedplaatjes-aggregatieremmers.....................................................................................................59
Anticoagulantia...................................................................................................................................60
Lipidenverlagendemiddelen..............................................................................................................60
Coronairerevascularisatie..................................................................................................................62
Hart-longmachine..............................................................................................................................63
Ischemischhartlijden-casuïstiek..............................................................................................................64
Cardiovasculairepreventie.........................................................................................................................70
Risicofactoren..........................................................................................................................................70
Roken.................................................................................................................................................71
Cholesterol.........................................................................................................................................73
Gewicht..............................................................................................................................................75
Lichaamsbeweging.............................................................................................................................77
Bloeddruk...........................................................................................................................................77
Cardiovasculairepreventie-casussen......................................................................................................80
Cardiomyopathieën......................................................................................................................................88
Cardiomyopathieën..................................................................................................................................88
Gedilateerdecardiomyopathie(DCM)......................................................................................................89
Hypertrofecardiomyopathie(HCM)ofhypertrofieobstructievecardiomyopathie(HOCM).....................92
Restrictievecardiomyopathie...................................................................................................................98
AritmogeneRV-cardiomyopathie(ARVC)..............................................................................................101
Aritmogenecardiomyopathie(ACM)......................................................................................................102
Non-compactiecardiomyopathie(LVNC)...............................................................................................103
Takotsubocardiomyopathie...................................................................................................................104
Hartfalen......................................................................................................................................................105
1
, asus-eenpatiëntmethartfalen.............................................................................................................117
C
Pericardialeaandoeningen.......................................................................................................................122
Pericard..................................................................................................................................................122
Acutepericarditis....................................................................................................................................122
Pericard-effusie......................................................................................................................................125
Tamponade............................................................................................................................................127
Pericarditisconstrictiva..........................................................................................................................129
Endocarditis...............................................................................................................................................132
Congenitalehartaandoeningen(bijvolwassenen).................................................................................138
Aangeborenhartafwijkingen...................................................................................................................140
Acyanotischehartafwijkingen.................................................................................................................141
Atriumseptumdefect(ASD).............................................................................................................141
Ventrikelseptumdefect(VSD).........................................................................................................143
Patenteductusarteriosus(PDA)......................................................................................................144
Congenitaleaortaklepstenose.........................................................................................................145
Congenitalepulmonalisklepstenose................................................................................................146
Coarctatioaortae..............................................................................................................................147
Cyanotischehartafwijkingen..................................................................................................................149
Tetralogievanfallot(TOF)................................................................................................................149
Transpositievandegrotevaten.......................................................................................................150
Atrio-venticulariseptumdefect(AVSD)............................................................................................151
Eisenmengersyndroom...................................................................................................................152
Pulmonalehypertensie..............................................................................................................................154
Oorzaken................................................................................................................................................155
PHdoorlinkerhartlijden...................................................................................................................156
PHdoorlonglijdenen/ofhypoxemie.................................................................................................156
A.pulmonalisobstructie...................................................................................................................156
Onduidelijkmechanisme..................................................................................................................156
Pulmonalearteriëlehypertensie(PAH)............................................................................................156
Screening...............................................................................................................................................158
Klachten&klinischebevindingen...........................................................................................................159
Evaluatie&prognose.............................................................................................................................160
Diagnostiek............................................................................................................................................160
Prognose................................................................................................................................................166
Behandeling(grotelijnenkennen!).......................................................................................................167
Hypertensiefhart-envaatlijden................................................................................................................171
Oorzakenvanhypertensie.....................................................................................................................175
Essentiële/primairehypertensie.....................................................................................................176
Metaboolsyndroom..........................................................................................................................177
Diagnostiekvanhypertensie..................................................................................................................178
1.BevestigingvanverhoogdeBD/hypertensie..............................................................................178
2.Evaluatieglobaalcardiovasculairrisico........................................................................................181
3.Secundaireoorzakennagaan......................................................................................................184
Aanpakvanhypertensie.........................................................................................................................190
Niet-medicamenteus-levensstijl......................................................................................................191
Medicamenteus................................................................................................................................192
Combinatietherapie..........................................................................................................................197
Interventioneel..................................................................................................................................199
Therapeutischeaanpakinspecifiekecondities......................................................................................199
2
, arttonen&geruis.....................................................................................................................................207
H
Klepaandoeningen-mitraalkleplijden.....................................................................................................210
Mitraalstenose........................................................................................................................................210
Mitralis-insufficiëntie(MI)........................................................................................................................214
Mitralisklepprolaps=ziektevanBarlow.................................................................................................219
Klepaandoeningen-aortakleplijden........................................................................................................221
Aortaklepstenose...................................................................................................................................221
Aortaklep-insufficiëntie(AI)....................................................................................................................227
Tricuspidkleplijden..................................................................................................................................231
Pulmonaliskleplijden...............................................................................................................................232
Klepaandoeningen-casus........................................................................................................................233
Klepaandoeningen-cardialeheelkunde.................................................................................................237
Aortaklepstenose(AS)...........................................................................................................................237
Aortaklepstenose(AS)-chirurgie..........................................................................................................238
Mitralisklepinsufficiëntie(MI)..................................................................................................................247
Mitralisklepinsufficiëntie(MI)-chirurgie.................................................................................................250
Ventrikelseptumruptuur(VSR)...............................................................................................................254
ECMO,harttransplantatie&VAD’s...........................................................................................................256
Cardialepathologie....................................................................................................................................273
Pathologievandebloedvaten................................................................................................................273
Arteriosclerose.................................................................................................................................273
Atherosclerose.................................................................................................................................273
Vasculitis..........................................................................................................................................275
Ischemischehartaandoeningen.............................................................................................................275
Myocarditis.............................................................................................................................................277
Pericarditis.............................................................................................................................................277
Trofischestoornissen.............................................................................................................................278
Hypertrofecardiomyopathie.............................................................................................................278
Stapelingsziekten.............................................................................................................................278
Abnormaalinterstitium......................................................................................................................279
Klepaandoeningen.................................................................................................................................279
Infectieuzeendocarditis....................................................................................................................279
Ritmestoornissen.......................................................................................................................................281
Bradycardie-mechanismen..................................................................................................................282
Sinusknoopziekten...........................................................................................................................282
AV-geleidingsstoornissen.................................................................................................................284
Bundeltakblok...................................................................................................................................285
Bradycardie-behandeling.....................................................................................................................286
Tachy-aritmieën-mechanismen............................................................................................................287
Tachy-aritmieën-focalemechanismen..................................................................................................287
Automaticiteit....................................................................................................................................288
Getriggerdeactiviteit........................................................................................................................290
Tachy-aritmieën-reentrycircuits/cirkel-activiteit....................................................................................292
Cirkelritmestoornissen......................................................................................................................292
Prikkelbaarheid.................................................................................................................................293
Tachy-aritmieën-cirkelritmestoornissen................................................................................................293
Kentbundel......................................................................................................................................293
Wolff-Parkinson-Whitesyndrome(WPW)........................................................................................294
Tachyaritmieën-ventriculair..................................................................................................................296
3
, entrikeltachycardie(VT)................................................................................................................296
V
Ventrikelfibrillatie(VF)......................................................................................................................298
Tachyaritmieën-supraventriculair.........................................................................................................299
AV-nodalereentrytachycardie(AVNRT)..........................................................................................299
Ectopischeatrialetachycardie(EAT)...............................................................................................300
Multifocaleatrialetachycardie(MAT)...............................................................................................301
Voorkamerflutter...............................................................................................................................301
Voorkamerfibrillatie(VKF=AF)........................................................................................................302
Tachyaritmieën-behandeling................................................................................................................306
PSVT-behandeling...............................................................................................................................309
EAT&MAT-behandeling......................................................................................................................310
VKF-behandeling.................................................................................................................................310
Flutter-behandeling..............................................................................................................................318
PolymorfeVT(PMVT)-behandeling.....................................................................................................318
Regelmatigenbredecomplexen-behandeling.....................................................................................319
Casus-patiëntmetpalpitaties.................................................................................................................321
Casus-patiëntmetrecurrentepalpitaties..............................................................................................325
Casus-Patiëntmetplotsedood..............................................................................................................336
Oorzakenvanplotsedood.....................................................................................................................339
Commotiocordis..............................................................................................................................340
Coronairarterieanomalieën..............................................................................................................340
Anderecardiovasculaireaandoeningen...........................................................................................340
AritmogeneRVcardiomyopathie(ACMP)........................................................................................341
Hypertrofecardiomyopathie.............................................................................................................341
Long-QTsyndromen(LQT)..............................................................................................................342
PreventievanSCD.................................................................................................................................342
Syncope......................................................................................................................................................344
Vasovagalesyncope=neurocardiogenesyncope=apppelflauwte......................................................347
Orthostatischehypotensie......................................................................................................................351
Rijgeschiktheid...........................................................................................................................................353
Cardialebeeldvorming-RXthorax..........................................................................................................355
Cardialebeeldvorming-nucleairecardiologie.......................................................................................363
Invivoonderzoekenincardiologie.........................................................................................................363
Myocardperfusiescintigrafie:(gated)SPECT.........................................................................................363
Hartfunctiescintigrafie:GBPS.................................................................................................................367
Positronemissietomografie(PET)........................................................................................................368
Cardialebeeldvorming..............................................................................................................................371
Echocardiografie....................................................................................................................................371
CardialeMRI..........................................................................................................................................377
CardialeCT............................................................................................................................................380
Hartonderzoek............................................................................................................................................382
4
, Ischemisch hartlijden - casus 1
CASUS
nonkel Frans
● een gezellig nazomer familie-BBQ in de Ardennen
● iedereen eet Bourgondisch, de sfeer zit goed
● een half uurtje na de BBQ
○ nonkel Frans voelt zich onwel
○ hij vermeldt pijn achter het borstbeen: "Ik heb het zuur. Ik heb weeral teveel gegeten”
○ jij bent de toekomstige dokter van de familie, dus zegt Nonkel Frans tegen jou: "Hé, wat doe
ik hieraan?"
differentieel diagnose
● indigestie met vagale symptomatologie
● slokdarm spasmen: krampachtige pijn, niet uitstralend naar arm of tanden
● pericarditis
● angina pectoris
● aorta ruptuur
● pulmonair probleem: infectie, embool, pneumothorax…
● galkoliek
anamnese
● eerder doorgemaakt? → ja, elke keer dat hij teveel eet
● klacht
○ waar zit de pijn?
○ uitstraling?
■ naar linker bovenarm tot ulnaire zijde van hand, hals, beide kaken, tandpijn →
ischemisch hartlijden
■ naar rug → aortadissectie
■ naar epigastrium → indigestie
■ naar rechter hypochonder → galkolieken, cholecystitis
■ naar laterale, basale thorax → pleurale irritatie door longembolen of pneumonie
○ type pijn?
■ scherp, stekend, ademhalingsgebonden & houdingsgebonden (beter bij voorover
buigen): pericarditis
○ verloop, progressief karakter?
■ voorbije weken abnormaal kort van adem bij minste inspanning → instabiele angor
■ geen pijn
● medicatie
○ Perindopril 5 mg/dag → ACE-inhibitoren (bloeddrukverlager)
○ Metformine 2x 850 mg/dag → antidiabeticum
○ Simvastatine 40 mg/dag → statine (cholesterol-verlager)
● CV-risicofactoren
○ leeftijd: 66 jaar
○ obees (BMI 31)
○ hypertensie
○ diabetes mellitus
○ hypercholesterolemie
○ roker tot 52ste
⇒ obv karakter van de klacht + CV-risicofactoren: angina pectoris
5
