Cardiovascular Case Study : Cardiovascular Case Study

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.

Explain in detail how the following systems adapt, in the short term, to exercise. Please also make brief comment about long term adaptation in each case

TROPONINS – Markers of choice. Elevated between 4 and 6 hours after the onset of an acute MI and remains elevated for 8-12 days.

You need to explain to him the s/s of blood clotting (since he may have too low an INR d/t treatment and he needs to know this). Explain that his a-fib puts him at risk for blood clots.

The right ventricle fills up  tricuspid valve closes  right ventricle contracts  pulmonary valve opens  the blood flows into the pulmonary artery  pulmonary valve closes  pulmonary artery splits into two vessels each going to the lungs.

3) Is her history of rheumatic fever relevant to her current symptoms? Explain. Rheumatic fever caused by Group A Streptococcus bacteria may cause damage to heart tissues including valves. Overtime, congestive heart failure may have developed. However, the pulmonary semilunar valve seems to be the issue in this case study, whereas rheumatic fever normally affects left heart tissue.

Coronary artery disease (CAD) is the commonest heart disease in the United States1. Approximately, 29% of patients with Myocardial Infarction ( MI ) present with ST- elevation Myocardial Infarction ( STEMI )2. STEMI is the result of complete occlusion of a major epicardial coronary artery due to thrombus formation. STEMI from a small coronary artery presenting as substantial EKG abnormalities similar to occlusion of a major artery and hemodynamic instability is a rare entity. The epidemiology, typical clinical presentation, outcomes, and optimal management in this group of patients are not sufficiently known.

The patient has been diagnosed with atrial defibrillation and congestive heart failure. There is no visible jugular vein distention or pulsations on either side of the neck. The patient was not comfortable with removing her sweater, therefore, pulsations, lifts, or heaves were not seen if present. Palpated and auscultated the carotid arteries for vascular sounds, no bruits heard. Heart sounds were auscultated with the bell and diaphragm of the stethoscope. S1 82/min, even and regular. S2 85/min, even and regular. S3 82/min, even and regular. S4 83/even and regular. No murmurs were heard. The apical pulse rate was 92 bmp, regular and was accessed with patient in sitting position and between the 4th and 5th intercostal space. Patient stated

A heart murmur is an abnormal heart sound. Instead of the normal “lub-dub” sound of each heartbeat, a veterinarian will hear a whooshing sound in between the “lub” and the “dub.” This whooshing sound is the murmur, and it is caused by turbulent blood flow through the heart. In some cases, a murmur indicates an anatomical defect in the valves or chambers in the heart. If a valve does not open or close

A heart murmur is a sound coming from the heart and can indicate a heart disorder. The murmur sounds like a swishing or whooshing noise. Heart murmurs can be caused by Structural heart defects present from birth, Valvular heart diseases, an infection in the heart, also known as endocarditis, mitral valve prolapse, heart failure, and congenital heart defects. There are two types of murmurs. They are innocent murmurs and abnormal murmurs. The innocent murmur is one that is not a threat in any type of way. The abnormal murmurs is an actual medical condition caused by some sort of abnormality with the heart itself. Heart murmurs like the innocent ones are harmless and do not require any treatment. Although, for others medication, surgery or just

The other type of LSHF is diastolic failure. This occurs when the left ventricle loses its ability to relax normally. Thus, the muscle becomes stiff, ventricular hypertrophy, and the heart can’t fill with enough blood during the resting period between each beat, leading to a

It occurs when the muscles have to work harder to pump the blood through the narrowed pulmonary valve resulting increased in right ventricle pressure. This defect is closely associated with pulmonary stenosis.

Heart failure occurs when structural or functional cardiac disorders cause one or both ventricles of the heart not to pump effectively to meet the demands of the body (Lopez-Pazos, et al., 2011). Some symptoms of heart failure include: dyspnea on exertion, cough, fatigue, edema/weight gain, chest pain, palpitations, right upper abdominal pain or fullness, orthopnea, hemoptysis, bibasilar crackles, nocturnal dyspnea, pallor, cyanosis, tachycardia, weakness, exercise intolerance, murmur, S3 gallop, and hepatomegaly (Cash & Glass, 2014).

Heart failure is a complex clinical syndrome in which the heart is unable to pump sufficient amounts of blood to meet the body’s metabolic demands. Specifically, the left side of the heart receives oxygen rich blood from the pulmonary veins and is responsible for systemic oxygenation by pumping this blood through the aorta to the rest of body. The left ventricle provides most of the heart’s pumping power; it has a thick muscular wall . When the left ventricle weakens and becomes inefficient in its ability to…. the left side

In the case of Martha, she had an episode of rheumatic fever in her twenties. Rheumatic fever, of which is an illness brought on by Streptococcus A, produces a protein that attaches to the cell wall of an organism causing inflammation. This can affect the heart and cause pancarditis, which is an infection of the entire heart. Endocarditis is the portion of pancarditis that causes valvular disorders. Though the pulmonic valve is not commonly affected, it is still a possibility. The valve apparatus can become fused leading to stenosis years after a rheumatic fever episode that is acute, and damage can become progressive if there are subsequent episodes (Chin, 2014). With Martha 's murmur being low in pitch and more of a rumbling, it is considered a narrowing of the valve or stenosis. The murmur is located left of the sternal border and in the upper portion. This is the pulmonic valve region, which would make this a pulmonic valve stenosis (Rao, 2014). According to Rao (2014), the murmur is due to the leaflets of the pulmonic valve not completely opening. This causes a resistance of the blood flowing foward through the valve, which happens during systole of the ventricles. This further causes a turbulence of the blood and makes the sound of the murmur. Pulmonic valve stenosis can then lead to ventricular hypertrophy of the right ventricle, which is proportional to how obstructed the valve becomes (Rao, 2014).