Coronary Artery Disease Case Studies

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 (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.

A progress note from Dr. Chweyah, dated 06/26/2017, indicated that the claimant presented for follow-up of gout, muscle weakness, and weight loss. He had ongoing weakness of the legs with knee pain. He stated that her weight drop had stopped. His current weight was 210 pounds. Objective findings showed a pulse rate of 105 with a blood pressure of 92/60. His BMI was 28.56. He was diagnosed with an acute pain in both knees, muscle weakness in the legs, chronic gout, and weight loss. A referral to neurology and medications were recommended.

12/24/15 Progress Report describes that the patient has right knee pain. The pain is frequent. It is aching and burning in quality. The current pain level is 0/10 and worst pain is 4/10. Bending, squatting, walking, weight bearing, changing clothes and ROM aggravate the pain. Rest, ice,

The patient is an 86-year-old female who was brought to the emergency room because of bilateral leg swelling. She was recently discharged from the Arbor Glen Reha and she's developed increasing bilateral leg edema. Her medical history is significant for hypothyroidism, chronic kidney disease stage II, anemia which is a chronic, ulcer in the sacral ulcer stage III and she denies any other symptoms. Review of the lab work does show a bump in her creatinine from 1.27 baseline in February of 18 to 1.54 on this admission with an increase in her BUN. She also demonstrates a mild anemia of 10 with a MCV of 90. Her edema is described as massive by the attending physician. PT examination reveals she needs significant assistance to moneuver her

Past Medical History: The patient has a history of end-stage renal disease secondary to IgA nephropathy, hypertension, alcohol abuse, biopsy proven liver cirrhosis, history of right leg cellulitis,

Mary Martinez is a 72 year-old female that is here in Prep and Holding for a scheduled elective right knee replacement surgery. I am performing a final pre-op exam at 6am. The patient is awake, alert, and oriented to name, place, and date. Patient has no known allergies. Patient stated her past medical history included: atrial fibrillation, hypertension, coronary artery disease, Type II diabetes mellitus, hyperlipidemia, and osteoporosis. Medications were reviewed with patient. Patient stated taking Coumadin, aspirin, metformin, metoprolol, calcium, and simvastatin. The last time, she has taken her medications were last night at 2000, including her warfarin and aspirin. She has been NPO since midnight. Physical assessment was performed. Patient complains of chronic pain in the right knee. Pupils are equal and reactive. Lung sounds are clear with auscultation on all lobes without any respiratory distress noted. Respiratory rate is 18 breaths per minute. Patient is on room air with oxygen saturation of 97%. Heart sounds are irregular with no murmur noted. Heart rate ranges from 92 to 120 beats per minute (bpm). Blood pressure is 140/67. Labs were reviewed. Abnormal values were International normalized ratio (INR)

Patient is a 60 year old male Caucasian that presented to ED with chest pain in the left precordial area. Patient describes the pain stabbing and with occasionally pressure-like that started the day before. He also say that the pain is sporadic, worse with movement 10/10 does not radiated, but is associated with nausea, headache, dizziness, palpitation, diaphoresis and SOB. Has past medical history significant for CAD post stent placement, atrial fibrillation, DM Type 2, and HTN. Upon arrival to the ED he was given aspirin and Nitroglycerine that improved his pain to 7/10 his blood pressure was 166/82 Patient was admitted for further evaluation and management.

Leo is a middle-aged male, who has been diagnosed as having a disorder called atherosclerosis. Atherosclerosis is a vascular disease that occludes (blocks) arteries and weakens arterial walls (2014, Patton & Thibodeau p.394). Leo is experiencing pain while walking, because the hardened of the arteries is blocking the flow of blood to his legs. In addition, the thickening of and calcification reduce the flow of blood to the tissues”(2014, Patton & Thibodeau p.397). Individuals that suffering with this life threaten, blood vessel disorder are living in pain. The potential damage is cause can lead to a myocardial infarction. If Leo substance damage to this extreme he may benefit from a surgical replacement to restore his blood flow (2014, Patton & Thibodeau). In essence, there is no cure for atherosclerosis. Often people opt for surgery because treatment only slow down or halt the disease. The pain Leo feels when he walks is triggered by stiffening or hardening of the artery walls. When plaque clogs up the artery, it disrupts the flow of blood in the entire body. Leo’s physician may recommend vasodilators drugs to trigger the smooth muscles of the arterial walls to relax and dilate his arteries (2014, Patton &

Coronary artery disease (CAD; also more simply referred to as coronary heart disease) is a specific type of atherosclerosis, which is in turn a form of arteriosclerosis (Dulson, Fraser, LeDrew, & Vavitas, 2011). All of these medical conditions entail the same problem, which hinders proper blood flow of oxygenated blood in the arteries: the sclerosis (that is, hardening) of arteries in the circulatory system (Sclerosis [medicine], 2016). Arteriosclerosis is a general term used to describe the stiffening of arteries particularly resulting from the process of mere ageing, but may also occur due to the presence of other aspects such as hypertension and/or the accumulation of plaque in and/or on the arterial walls, which consists of numerous components including lipids (cholesterol in particular), calcium, and other substances present within the bloodstream; atherosclerosis is specifically associated with plaque buildup in the arteries (if it occurs in one of the coronary arteries, which supply oxygenated blood to the myocardial tissue itself, it is further classified as CAD) (Difference between arteriosclerosis and atherosclerosis, 2014; Dulson et al., 2011). CAD is a common, serious condition that may be fatal; hence, it is imperative that one understands the pathology, diagnosis, and treatment of this disease in order to help decrease its prevalence. This report is concerned with explaining the physiological effects of CAD on the body, latter-day

Kevin has two blocked coronary arteries which means he has coronary artery disease and the best procedure to fix this would be to have coronary artery bypass surgery. He also has metabolic syndrome. First, he has high blood pressure of 145/90, second, his cholesterol levels are high - at a range of 155 mg/dL LDL and 38 mg/dL HDL, third he has high triglyceride level of 165 mg/dL, and last but not least he is overweight.

The patient stated that he began experiencing painful swelling in his right knee over a decade ago. A large mass grew around the knee and he underwent a total knee arthroplasty. Not long after the arthroplasty of his right knee, he began experiencing similar symptoms in his left knee and right elbow.

The paramedic could determine why nitroglycerin didn't work because of alcohol. It is a positive impact of having too much alcohol in the body to interact with the medications. Taking nitroglycerin may cause dizziness or fainting. Feeling dizziness, anxiety, or shortness of breath is because the blood flow is not enough to function the heart muscle. When a person has MI or myocardial infarction it will become permanent damage of the muscle and tissue in the heart. If doesn't have enough oxygen, this caused chest pain or angina results. “This occurs when fatty deposits known as plaque causes a narrowing of the arteries, this is called Atherosclerosis.” When coronary arteries are clog, or narrowed it will become difficult to pass through the

MEDICATIONS: (amiodarone) 100 mg daily, lisinopril 2.5 mg daily, simvastatin 20 mg daily, aspirin 1 tablet daily.

How socio-demographic factors such as, gender, age, ethnicity, and income influence the recognition of symptoms of acute coronary syndrome and delay medical treatment?