Bipa Case Study Essay

Patient complained she was short of breath and experiencing severe pain between her shoulder blades. She stated that she has been feeling nasuseated for the past 3 hours. She states she has a history of stable angina and is currently taking medication as needed. She states she did not take the nitroglycerin because she was not experiencing chest pain, just back pain. She states that her last check-up with the Pulmonologist showed that her EKG did not show any changes since her last visit. She denies episodes of syncope. The patient does report that she tripped over something on the floor, which resulted in her falling and hitting her back on a large table. In addition, she states that her heart rate has been ranging from 130/ 90 to 140/92. Patient states her Primary care physician placed her on blood pressure medication 2 months ago due to the increase.

In transport, patient received O2 at 4 liters via nasal cannula, baseline EKG, Normal Saline IV started in left hand, 325 mg aspirin by mouth (po). Patient complained she was short of breath and experiencing severe pain between her shoulder blades. She stated that she has been feeling nasuseated for the past 3 hours. She states she has a history of stable angina and is currently taking medication as needed. She states she did not take the nitroglycerin because she was not experiencing chest pain, just back pain. She states that her last check-up with the Pulmonologist showed that her EKG did not show any changes since her last visit. She denies episodes of syncope. The patient does report that she tripped over something on the floor, which resulted in her falling and hitting her back on a large table. In addition, she states that her heart rate has been ranging from 130/ 90 to 140/92. Patient states her Primary care physician placed her on blood pressure medication 2 months ago due to the increase.

Mr. S is a 29-year-old male with past medical history of (PMH) hypertension (HTN) and obesity who presented to local emergency room (ER) with headache and chest and back pain. Mr. s had been seen at urgent care three days prior for a headache and near syncope and was told to hold his metoprolol due to bradycardia. Due to health insurance related problem, he has been off amlodipine and lisinopril for a month.

Pain is processed by several parts of the brain, whereas the five senses are processed by specific areas in the brain. People also feel pain differently.

Aortic arch angiogram: shows right aortic arch with the following branching pattern (from proximal to distal): left common carotid, right common carotid, right subclavian artery. The origin of left subclavian (with anomalous origin) was not seen as it was ligated previously. However, the distal portion is filled with diluted contrats likely through a retrograde flow through the left vertebral artery. Patent Rt MAPCA with no intimal ingrowth was seen in the previously placed stent at the origin of Rt MAPCA. Dilated tortus RIMA which is likely profusion the right upper lung lobe (aortopulmonary collaterals) left BT shunt is wide patent (connected left common carotid artery to the interposition graft) with good caliber with mild narrowing at its insertion in the interposition graft.

Anomalous coronary arteries currently affect approximately 1% of the population. And due to the lack of frequency in which coronary anomalies occur, interest and ability to research these anomalies is lacking. The issue is that athletes, specifically young healthy athletes, are at large risk of death from coronary anomalies. In fact, anomalies cause 11.8% of deaths in amateur athletes. This has lead to a current increase in research of these anomalies. Coronary anomalies are typically present at birth, but due to their lack of symptoms they are rarely diagnosed. Encompassing a wide spectrum, these anomalies include but are not limited by: separation of the LAD and LC from the valsalva, absent left circumflex, ectopic origin of the RCA, small

42 years old male patient with no past medical history, was brought to the emergency department by paramedics. He had flew from Hawaii to Los Angeles for Business. He was having lunch with his colleagues and suddenly collapsed and went into cardiac arrest. EMT reported he went into ventricular fibrillation arrest, status post defibrillator (countershock) x 5, epinephrine was given x3 then amiodarone 450 mg and return of spontaneous circulation (ROSC) was noted. In the emergency department, patient was intubated and hemodynamic stable. On the process, he developed acute respiratory failure with hypoxia, leukocytosis, aspiration pneumonia, acute encephalopathy, hematuria, hypertension, and bilateral deep vein thrombosis. Acute respiratory failure with hypoxia is caused by inadequate alveolar ventilation (hypoventilation) and impaired gas

The two most common causes of aortic stenosis severe enough to require surgery are calcification of congenital bicuspid aortic valves and degenerative calcification of tricuspid aortic valves (Roberts WC, Ko JM. ) Aortic valve calcification, scored by computed tomography (CT), can be helpful in diagnosis of severe aortic stenosis in the patient. (Marincheva-Savcheva G, Subramanian S, Qadir S, et al.)

3. Calculate the client's target heart rate at 60% and 80% using the Karvonen formula.

As seen in the figure, CMR revealed a large, broad-based aneurysm (12 mm x 25 mm) at the base of the right ventricle, under the anterior aspect of the tricuspid valve annulus. The aneurysm was thin-walled with paradoxical motion and transmural late gadolinium enhancement (LGE). Global right ventricular systolic function was moderately depressed with and ejection fraction of 31%. Left ventricular size and ejection

Chronic periaortitis refers to a fibro-inflammatory process involving the aorta, commonly infrarenal abdominal aorta. The involvement of aortic root and ascending aorta are relatively rare. The aetiologic possibilities are diverse and include neoplasms, infections, trauma, radiotherapy, surgery, drug intake and idiopathic retroperitoneal fibrosis. Periaortitis is rarely evident in transthoracic echocardiogram as the involvement of aortic root is rare, and the visualization is suboptimal. We report two cases of periaortitis where a circumferential periaortic cuff was detected by transthoracic echocardiogram.

When one studies calcified aortic valve disease (CAVD) for the purpose of this paper it will be referred to as AS, microscopically, one can see indicators of chronic inflammatory process, disruption to the basement membrane, and lipid accumulation in the fibrosa (Akerstrom, Barderas & Rodriquez-Padial, 2013). Hypertension, smoking, and hypercholesterolemia, all common cardiovascular risk factors, influence the changes that contribute to CAVD.

A 61-year old man with a history of coronary artery by-pass surgery (CABG) before twelve years ago, low ejection fraction, hypertension and diabetes mellitus came to our clinic because of anginal pain. Cardiac catheterization was performed, and we found three vessel coronary diseases with occluded left internal mammary artery bypass on the anastomosis in the left anterior descending artery, occluded saphenous vein graft for the right coronary artery, and two aneurysms (the first small 8x6mm and the second larger 18x10mm) on the saphenous vein graft for the first obtuse marginal artery with significant stenosis (white arrows, Video 1). It was suggested again CABG, but because of the

Have you ever had a colonoscopy or endoscopy – where they take a camera and look through your mouth down into your stomach; or a camera that goes in your rectum that looks through your bowel and intestines?

Cardiac: Regular rhythm without murmur, normal S1and S2. One plus edema to bilateral lower extremities. Capillary refills are presents and carotid bruits are absent.