A 46 -year -old patient was hospitalized to the intensive care department of hospital. He complained of severe, pressing pains behind the breastbone that go on for 1,5 hour. From anamnesis: during the week he worked much, slept few, smoked more then usual, drank tea and coffee. Up to this time he believed that he was an absolutely healthy man. He went in for sports. On examination: general condition is very bad, paleness of skin, acrocyanosis. By lung auscultation: vesicular respiration, no crackles, respiratory rate is 28 for min., heart tones are muffled, unrhythmical. Arterial pressure: 100/70 millimeters of mercury. On ECG: periodic ciliary arrhythmia of atrium with pulse rate 360 in minute, right bundle-branch block, upsurge of ST segment in I, AVL, V1- V2 leads. On blood analyze: leucocytes: 9,2 * 109 g/l, other indices are in the limit of norm. What forms of heart pathology has a patient? It should be argued. What cause-effect relation is between the forms of pathology that you name? What caused the pain between the breastbones? What extra examinations would be lead for the confirmation of myocardial destruction?

Human Anatomy & Physiology (11th Edition)
11th Edition
ISBN:9780134580999
Author:Elaine N. Marieb, Katja N. Hoehn
Publisher:Elaine N. Marieb, Katja N. Hoehn
Chapter1: The Human Body: An Orientation
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A 46 -year -old patient was hospitalized to the intensive care department of hospital. He complained of severe, pressing pains behind the breastbone that go on for 1,5 hour. From anamnesis: during the week he worked much, slept few, smoked more then usual, drank tea and coffee. Up to this time he believed that he was an absolutely healthy man. He went in for sports. On examination: general condition is very bad, paleness of skin, acrocyanosis. By lung auscultation: vesicular respiration, no crackles, respiratory rate is 28 for min., heart tones are muffled, unrhythmical. Arterial pressure: 100/70 millimeters of mercury. On ECG: periodic ciliary arrhythmia of atrium with pulse rate 360 in minute, right bundle-branch block, upsurge of ST segment in I, AVL, V1- V2 leads. On blood analyze: leucocytes: 9,2 * 109 g/l, other indices are in the limit of norm. What forms of heart pathology has a patient? It should be argued. What cause-effect relation is between the forms of pathology that you name? What caused the pain between the breastbones? What extra examinations would be lead for the confirmation of myocardial destruction?
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Step 1: Summarizing the case study

This case study presents a 46-year-old patient who was admitted to the intensive care department of a hospital due to severe chest pain. The patient's lifestyle, including high work stress, inadequate sleep, increased smoking, and consumption of stimulants like tea and coffee, coupled with his symptoms and ECG findings, suggest a heart condition. The following discussion will delve into the potential heart pathology, the cause-effect relationship between the symptoms and the suspected condition, the source of the chest pain, and the additional examinations required for a definitive diagnosis.

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