Health Information : Assessment Task Essay

A 68 year old male presented to the emergency department at 0800 hours via ambulance after experiencing chest discomfort and intermittent palpitations since 0500 hours. Prior to presentation, the patient stated he

The most common physiological process leading to a myocardial infarction is the occlusion of coronary arteries by a process known as atherosclerosis. In fact, atherosclerosis is present in more than 90% of persons with coronary heart disease.1

Thomas’ chief complaint was a persistent, crushing chest pain that radiates to his left arm, jaw, neck, and shoulder blade. He also described the pain as a squeezing sensation around his heart. The medical term for this patient’s chief complaint is angina pectoris. Angina pectoris is the medical term for the chest pain or discomfort due to coronary heart disease.

Nevertheless, there is an understandable and noticeable link between circulatory related diseases and lifestyle diseases, such as Coronary Heart Disease. Coronary heart disease can occur when fatty acids, such as cholesterol in an inadequate diet, build up in the walls of the coronary artery. These fatty deposits collect minerals and harden to become a plaque. Eventually, this plaque grows and can swells up, forming an aneurism. In some cases, this aneurism may burst leading to instant death. As it continues to grow and swell up, it finally blocks the artery completely and forms blood clots. This is known as coronary thrombosis. A myocardial infarction, or in other words as heart attack, occurs when no oxygen is able to reach the coronary artery and thus it is unable to fulfil its role in providing the heart muscle with a sufficient supply of blood. Heart attacks are very common in the society nowadays, especially occurring in smokers or obesity related diseases (Millar, June 2014)

Mr. Howard, a 57-year-old man, had a 3-month history of progressive typical anginal chest pain. He reported that the symptoms first occurred with heavy exertion and involved what he described as“heaviness” in his chest. The symptoms were promptly relieved with rest. Over the past weeks, he had been experiencing increasingly frequent episodes of chest pain and diaphoresis. The episodes had become more prolonged, and he had experienced one episode of pain occurring at rest after a heavy meal. Mr. Howard was moderately obese and had a 20-year history of hypertension, which was being treated. Other risk factors in Mr. Howard’s history include hypercholesterolemia (350 mg/dL), which he was attempting to treat with dietary modifications, and a 30-year two-pack-a-day smoking history which continued up to the present time. Mr. Howard previously had surgery for a bilateral inguinal hernia repair, cholecystectomy, and arthroscopic surgery on his left knew. He also gave a history of problems with gastric reflux and was currently taking cimetidine (Tagamet).

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.

In the emergency room, Rudd was connected to the cardiac monitor, labs were drawn and a 20-guage peripheral IV was started in the right arm. An IV infusion of nitroprusside was started and vital signs were recorded periodically. The Pain was assessed using a PQRST pain assessment method and Rudd rates throbbing pain bilaterally in the head with a pain score of 8 that aggravates with moving and does not radiate to elsewhere other than the head. The orthostatic BP shows no changes. The E.D physician decides to admit Rudd in CCU to further monitor his blood pressure and watch for any signs of organ damage. The E.D physician writes an order for pain management and transfer to CCU. The ER nurse

The pathophysiology of ACS includes the stable plaque forms get converted into unstable plaque forms.2 These unstable plaque forms have numerous thin fibrous cap cells, inflammatory cells, activated macrophages, and smooth muscle cells. Sympathetic activity increases myocardial contractility, pulse rate, blood pressure, and coronary blood flow which leads to plaque rupture or fissure. As the artery ruptures, it causes thrombus formation and ischemia in this particular artery. Depending on the condition, different thrombi could form. The unstable angina forms a small thrombus formation, NSTEMI forms a partial thrombus formation, and STEMI forms a complete and persistent thrombus. The risk factors involved in ACS are age, physical inactivity, and history of hypertension, diabetes, or angina. The signs of acute coronary syndromes are an acute heart failure, tachycardia, bradycardia, or heart blockage, and the symptoms of ACS consist of chest pain, pain in the extremities, nausea, shortness of breath, heavy

Mr. Bishop is here for routine followup of his chronic illness. He is treated with Alvesco 160 mcg two puffs twice daily, Atrovent two puffs three times daily and Ventolin as needed for his COPD. He reports good compliance and uses these inhalers as prescribed. He generally uses his Ventolin with exercise. He reports that he is running 1-2 miles a day and also doing a step tape daily and reports good exercise tolerance. He does not wake at night coughing or feeling short of breath. For his hypertension, he takes hydrochlorothiazide 25 mg, and amlodipine 5 mg, and simvastatin 20 mg for his hyperlipidemia. He takes these as prescribed and denies any side effects. He denies

Mr. Wilson, a fifty-three-year-old utility worker earns 73,000 dollars a year. At the time of his heart attack he mistook it for a heart burn, despite being the second time having one. When his wife called the ambulance he was given two options for hospitals, the city hospital or to the Brooklyn hospital. He chose the Brooklyn hospital, knowing that the city hospital would not treat him as fast. At the Brooklyn hospital he was given a drug to break up the clot blocking the artery to his heart. The medicine worked at first, however the clot reformed. He needed an angioplasty, but had to go to a different facility because the Brooklyn hospital didn’t have the resources the test there. In comparison to Mr. Miele who was also required to do an angioplasty and was done in

Alike all muscle in the body the heart requires its own constant supply of oxygen and nutrients. Out of three coronary arteries, large two and branching arteries supply oxygenated blood to the cardiac muscle. Any sudden block of these arteries or its branches causes starvation of heart from oxygen and this condition called “cardiac ischemia”. When myocardial ischemia exceeds a critical inception and overthrows cardiac cellular repair mechanisms deliberate to maintain normal operating function and homeostasis. Ischemia at this critical limit for prolonged period causes permanent cardiac cell injury or

Reichlin, T. et al., 2009. Early diagnosis of myocardial infarction with sensitive cardiac troponin assays. The New England Journal of Medicine, 361(9), pp. 858-867.

Coronary endothelial dysfunction is associated with various pathological impairments, such as the disruption of cardiovascular homeostasis, poor blood circulation, myocardial injury, the accumulation and adhesion of platelets and monocytes, the increase in vasoconstriction, increased expression of inflammatory factors, and impairment in vascular regeneration which increase the risk of atherosclerosis.

The formation of coronary thrombus on an atherosclerotic plaque, leading to total or sub-total occlusion of the coronary artery, is the key event that causes acute ischemic syndromes as

A Myocardial Infarction also known as a “heart attack” or acute coronary syndrome is a medical emergency that requires immediate intervention to prevent extenuating damage or death to the muscle that pumps the human body with oxygen therefore, life. Many of those who’ve suffered damage from a heart attack and survived are able to go back to enjoying a normal life if damage is limited with proper treatment and preventive lifestyle changes. This paper will encompass the pathophysiology that is a Myocardial Infarction, and discuss its warnings, treatment, prevention as well as where a patient could find communal support after discharge.