Pulse rate is at 72. The blood pressure was 140 / 95,which is suggestive of high blood pressure and related to his medical history. No heart murmur was noted, and no other abnormalities were noted.
Mr. Thomas’ has been diagnosed with an acute myocardial infarction (MI). A myocardial infarction is an “infarct of heart muscle caused by occlusion of one or more of coronary arteries” (Frucht, 2012 P.125). The common name for Mr. Thomas’ condition is a heart attack. A heart attack occurs if the flow of oxygen-rich blood to a section of heart muscle suddenly becomes blocked ( ). If the blood flow is not restored quickly, then that section of the heart muscle begins to die. Heart attacks have become the leading killer of both men and women in the United States. The main cause of heart attacks has
shortness of breath. Pain improved with sublingual Nitroglycerine and Aspirin given by EMS. On arrival to ED his blood pressure was 154/94, HR 70 bpm, RR 19 and SpO2 98% in room air. Heart, lung, abdominal and neurological examinations were unremarkable.
African American male that is seen today for followup post hospital discharge. He is a 48-year-old gentleman with complicated cardiac history as well as neurological history including congestive heart failure. History of strokes 01/2017, possible sick sinus syndrome. He has an implanted pacemaker that was placed in 06/2017, as well as hypertension. He was taken to the Central Hospital on 09/01 with presentation of chest pain, noted to be around his pacemaker site. He identified being in seizure and suddenly felt chest pain with shortness of breath, and was offered nitro, he developed headaches and dyspnea post nitro treatment, of note is that the EKG that was obtained during that process, did not identify any pacemaker spike despite having a
Hypovolemic shock is an urgent condition of rapid reduction of circulatory volume in the body, which can be created due to blood or plasma or body fluids loss (Kettley & Marsh, 2016, p. 31; Perner & Backer, 2014, p. 613). Blood loss can be induced by internal or external injuries, excessive perspiration or diuretics (Craft & et al, 2015, p. 852). Maureen Hardy’s hypovolemia has been precipitated by hematemesis.
The halothane anaesthetic binded with the RyR1 receptor at the depolarization process where the RyR1 receptor released abnormally large amount of calcium, leading to continuous muscle contraction and the excessive production of heat. The affected ryanodine receptor of the skeletal muscle induces calcium exit from the sarcoplasmic reticulum of the skeletal muscle, consequently accelerating biochemical reactions which cause severe muscle contractions and elevates the metabolic rate, resulting in respiratory and metabolic acidosis. The binding of the anesthetic to the receptor overwhelms the body’s ability to supply oxygen. Uncontrolled calcium release triggered by the binding of halothane anaesthetic, causes excessive muscle contractions and
Apical hypertrophic cardiomyopathy is a disease that mainly affects the apex of the heart and does not cause any obstruction. [1] These abnormalities in the heart muscle can cause a wide variety of symptoms. As the heart becomes stiff it increases the pressure in the left ventricle which can push blood back into the lungs, causing shortness of breath in exercise. Chest pain can occur as there is not enough oxygen available to the cardiac muscle due to insufficient blood supply. Palpitations and lightheadedness, along with other conditions can occur as a result of HCM. In addition to these discomforting symptoms, the patient may develop an arrhythmias that often goes unnoticed. An arrhythmia takes place as the electrical conduction of the heart is disturbed by the abnormal scattering of myocytes. The two most common arrhythmias are atrial fibrillation causing palpitations, and ventricular tachycardia that can be life threatening causing sudden death. Both conditions can be controlled with medication. [4]
Electrocardiographic changes can include left ventricular hypertrophy with repolarisation changes with T wave inversion and deep Q waves. In family members carrying HCM gene mutations, the electrocardiogram may demonstrate only minor abnormalities. The presence of non-sustained ventricular tachycardia, a risk factor for sudden death, should be tested for by means of Holter monitoring (Maron et al., 2003). At present, the diagnosis of HCM relies on echocardiography revealing symmetric or asymmetric hypertrophy. Secondary causes of hypertrophy, including valvular disease or systemic hypertension, should be excluded. 2D imaging of the left ventricle by echocardiography can confirm the diagnosis in affected patients. The ejection fraction, a measure of left ventricular systolic function, is typically preserved but there is usually evidence of diastolic dysfunction. These can be measured by tissue Doppler ultrasonography, which can show diastolic dysfunction before the development of hypertrophy (Maron, 2002). Histologically, HCM is characterized by cardiac myocyte disarray and fibrosis. Myocyte death and myocardial scarring may be present and coronary arteries may have thickened walls. This pathology can promote ventricular tachycardia and ventricular fibrillation (Maron, 2002).
In reviewing this unornate scenario, I would diagnose this 16 year old teen with Hypertrophic obstruction cardiomyopathy. Hypertrophic cardiomyopathy has to categories: Hypertrophic obstructive cardiomyopathy and hypertensive or valvular hypertrophic cardiomyopathy (Huether & McCance, 2012). Hypertrophic obstructive cardiomyopathy is the most commonly inherited cardiac disorder. It is characterized by thickening of the septal wall, which may cause outflow obstruction to the left ventricle outflow tract ( Huether & McCance, 2012). According to Huether & McCance, 2012, pg. 612, 33% of sudden deaths and dysrhythmias in younger athletes have been linked to this disorder. With above the teenager, he was an athlete and died suddenly on the field. Some of the signs and
OSHA adopts a standard to protect staff who are might be exposed to methylene chloride, a substance generally utilized as a part of industrial procedures, including paint stripping, pharmaceutical assembling and metal cleaning and degreasing. Exposure to methylene chloride favors the existence of tumor; affects the heart and causes skin and eye irritation.
Dantrium is the trade name for a generic drug called dantrolene-sodium which is classified as a direct-acting skeletal muscle relaxant. This drug is available for use in both intravenous and capsule form, the following information if for the intravenous product
Medications classified as dihydropyridines are procardia, norvasc, plendil, and cardene. These medications do not affect the cardiac conduction system. Dihydropyridines block calcium from moving into the cell membranes of the cardiac and smooth muscle. The cell tissue affected by these antihypertensive drugs is the cardiac muscle, SA & AV node, coronary arteries and arterioles, and the peripheral arterioles. Calcium channel blockers contract the heart by stopping calcium ions from going through the cell membrane during the plateau phase. This leads to failure of the calcium ions to release large amounts of calcium into the sarcoplasmic reticulum inside the cell. The calcium is needed to stimulate contractions by allowing the cross-bridge to form between the actin and myosin of
The main concern with HHNC is the client diuresing . This is a concern because of the loss of fluid, which in early stages results in hyponatremia . Later in the disease process, the patient will display elevated serum sodium levels, due to excessive fluid loss. This is a late sign that will be seen in a comatose patient suffering from HHNC . When a patient is constantly losing fluid , as such the case with HHNC, the patient’s serum level are increasingly elevated due to less fluid in the vascular space. This a main reason for elevate osmolality levels. Therefore , the patient will display signs of hypernatremia . Such signs, would include increased thirst or impaired thirst due to fluid loss and elevated serum sodium levels. Muscle weakness,
To conclude, hypertrophic cardiomyopathy, the cardiac sarcomere disorder, has been brought to the forefront of our attentions due to its rare yet fatal effects in young athletes; however, it is frequently asymptomatic and relatively common. In most cases, HCM will have no bearing on the person’s quality of life or lifespan. However, a minority, particularly young athletes, may be of an exception, with the myocardial disarray and thickened ventricular wall leading to complications. Dr Tom Riddington of the Guardian quotes: “since the 19th century more than 80 footballers are known to have died suddenly while playing, all young men, all otherwise apparently fit and healthy.” This highlights its significance with relation to sudden
A muscle relaxant is a pharmacologic aid use to alleviate tense muscles. It can be obtained as an over the counter drug or medication that requires a doctor’s prescription. I will be presenting the value of muscle relaxant to overstimulated muscles with a neurologic involvement such as spasticity, and how it can help mitigate and revive the person ability to recapitulate his capability to perform his/her activities of daily living.