Acute Coronary Heart Disease Essay

Ornato, J. P., Sayre, M. R., & Syrett, J. I. (2014). Chest pain and acute coronary syndrome. Emergency Medical Services: Clinical Practice and Systems Oversight, 2 Volume Set, 120.

In December of 1992, my paternal grandfather suffered a heart attack. He had been hauling several 50 lb. sacks of corn up into the deer feeder on his property by himself. He got into his truck, turned the ignition, put it into drive and before he could take his foot off the brake, he was dead. He was 68 years old. I was thirteen and that seemed so old. I remember that prior to the event there were many conversations within my family about the condition of my grandfather’s heart and cardiovascular system and how he needed to make lifestyle changes. I remember him taking nitroglycerine pills. I remember him coming to Dallas to go to an appointment so that they could perform tests with names like “stress EKG.” I

Cardiogenic shock, according to Werden et al. (2012), is the most common cause of death from an acute myocardial infarction (AMI) and has a chance of mortality from thirty percent to eighty percent. Infarction-related cardiogenic shock (ICS) complicates approximately five to ten percent of acute myocardial infarctions (AMI) and remains the leading cause of death in patients hospitalized from an AMI (Kolte et al., 2014). Kolte et al. (2014) also states that the incidence of cardiogenic shock is higher in patients over the age of seventy-five, and has higher prevalence in women, Caucasians, Asians, and Pacific islanders. This paper will discuss the pathophysiology, clinical manifestations, tools used to diagnose, and therapeutic management of cardiogenic shock.

The following summary is an updated case study of a 47 year old male patient, Jim who was diagnosed with Coronary Artery Disease. The patient did receive information on what CAD is and was informed that test were needed to fully diagnose and be evaluated for underlying conditions (high blood pressure, high blood cholesterol levels, diabetes and blockage. I will discuss the type of test needed for this condition and tests for any underlying conditions that are related to this disease. The type of treatment needed to control and lower his risk factor. I will also give the patient information about complementary and alternative medicine so the patient will be well informed about different types of treatment. The patient will be informed about the prognosis of the disease, and the options that the patient has to succeed in the changes in his lifestyle that are needed.

Coronary Artery Disease, also known as CAD, is the most common form of heart disease. (Heart and Stroke Foundation, 2009) Coronary Artery Disease obstructs the blood flow in vessels that provides blood to the heart which is caused by the buildup of plaque on the artery walls. (Rogers, 2011, p.87) (Heart and Stroke Foundation, 2009) Plaque is a yellow substance that consists of fat substances, like cholesterol, and narrows or clogs the arteries which prevents blood flow. (Heart and Stroke Foundation, 2009) Plaque can build up in any artery but usually favors large and medium sized arteries. (Heart and Stroke Foundation, 2009)

Acute coronary syndrome (ACS) is the most common form of cardiovascular disease.1 In 2006, about 733,000 ACS patients were discharged from hospitals costing the United States $150 billion annually.2 Eighty percent of these cases were either unstable angina (UA) or no ST- elevation myocardial infarction (NSTEMI), and the remaining 20% were ST-elevation myocardial infarction (STEMI).

In the evaluation of patients with chest pain, the preliminary ECG is a more clear-cut tool for early risk stratification with more recent recommendations indicating that ECG should be performed as early as possible, within 10 minutes of ED admittance. Early indicators associated with MI or ischemic complication such as ST segment elevation or depression allows rapid treatment aligning with the indicated complication. While the ECG may reveal significant indicators in certain situations, in other circumstances findings may be limited due to low diagnostic sensitivity

Coronary Heart Disease Coronary heart disease remains the most common cause of death in the United Kingdom. A statistic from the American Heart Association is that heart disease claims a life every 24 seconds. [www.americanheart.org] Another is that it is the largest single cause of premature death in the United Kingdom, responsible for 180 000 deaths annually. [www.americanheart.org]

A non-ST elevation acute coronary syndrome (NSTE-ACS) is a very common presentation to emergency departments everywhere, as well as primary care practices. Therefore, it is important that all providers be well informed on the effectivity of certain treatment regimens.

Our body system is not immune to pathological deficiencies. There exist numerous identified pathologies which compromise the regular functioning of a heart, but all heart-related pathologies are narrowed to a single condition known as Acute Coronary Syndrome (ACS). This is the term properly used in reference to the different identified clinical entities threatening the cardiovascular system. ACS is the result of the progressive or complete sudden blocking of the arteries or veins; this prevents an appropriate blood flow through the circulatory system, and as a consequence, the body is unable to receive enough oxygen and nutrients to meet its daily necessities.

CHF suffers 1.5-2% of the world's population [74]. The prevalence of CHF in the European population reaches 2.0%, in US - 2.2%, and in Russia - 6% and significantly increases with age [34, 63]. Currently, the number of patients with heart failure is increasing in all developed countries. This is due to an increase in survival in patients with cardiovascular disease, in particular, acute coronary syndrome, and thus objectively predisposed to the development of heart failure, as well as the steady trend to an increase in the population share of older age groups [79,

Weakness in the study is that it allowed participants in with previous cardiovascular events to be able to participate in the study. Though the article further stated that it excluded participants specifically with AMI events in the last 12 months, it allowed patients with history of angina to participate (MacIntyre, 2015). The weakness that I see in this decision is that there is a possibility that individuals with angina cases were misdiagnosed as something less severe than what they actually have (MacIntyre, 2015). Limited Variation in ethnicity could also be considered a weakness in this study. Listed below is the statistical breakdown displaying percentages of total participants for cases as well as for controls.

Our body system is not immune to pathological deficiencies. There exist numerous identified pathologies which compromise the regular functioning of a heart, but all heart-related pathologies are narrowed to a single condition known as Acute Coronary Syndrome (ACS). This is the term formally used in reference to the different identified clinical entities threatening the cardiovascular system. ACS is the result of the progressive or complete sudden blocking of the arteries or veins; this prevents an appropriate blood flow through the circulatory system, and as a consequence, the body is unable to receive enough oxygen and nutrients to meet its daily necessities.

Once at the hospital tests will be done to rule out other chest pain related causes. The first test that will be done is an Electrocardiogram or an EKG, which records the hearts electrical activity. Damaged heart cells are not able to produce electrical impulses which will produce abnormal EKG results. Elevations in the ST waves on an EKG are classified STEMI and are present in over ninety percent of myocardial infarctions who had a complete occlusion to an artery (Cardiac Emergencies, n.d.). NSTEMI is where there is no elevation of the ST wave and is indicative that a full occlusion has not occurred (Cardiac Emergencies, n.d.).

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