Question

CASE STUDY A Myocardial infarction Ms. X, aged 55 year and "Indigestion. He take her to the eme very anxious, and her pressure is 90/60. a CAS Esse Ms. year past a ne and feel blur her eral effects of shock. for ECG are attached, la enzymes and electro action involucrolytes. Tentative determina tion that indicates Ms job as a high school int and Svears, has been complaining of severe fatigue - Her son is quite concerned and decides to emergency department. On arrival she appears and her facial skin is cool and clammy, her blood 60. and the pulse is around 90, weak, and irregular. an intravenous line is opened, and leads given oxygen, an intravenous line is on ached. Blood is taken for determination of serum ed electrolytes. Tentative diagnosis is myocardial volving the left ventricle. Her son provides informa indicates Ms. X is a long time smoker, has a stressful gh school teacher, is recently separated after 20 years fearful of losing the family home. She has of marriage, and is fearful of losing the family seemed to be more fatigued and stopped going to the gym ut 18 months ago. She has begun to rely on "fast foods like and fried chicken and cooks infrequently. Her father had died of a heart attack at age 50. She had also noticed more fatigue and intermittent leg pain when waiting or climbing stairs at work. Generalized atherosclerosis is suspected 1. List the high-risk factors for atherosclerosis in this patient's history. 2. Describe how atherosclerosis causes myocardial infarction. 3. It is suspected that the indigestion reported in the history was really angina. Explain how this pain may have occurred. 4. Explain each of the admitting signs. 5. What is "atypical" in Ms. X's symptoms? How does this affect treatment and prognosis? 6. What information do serum enzyme and electrolyte levels provide? 7. What purpose does the ECG serve? It is determined that Ms. X. has a large infarct in the anterior ion, which leads to of bicarbonate left ventricle. rt function and, in hich may prevent Ms. X. is showing increasing PVCs on the ECG. State the cause and describe the effect if these continue to increase in frequency. n day 6 after admission Ms. X is preparing to go home th her son and they receive instructions on lifestyle odifications that are desirable if Ms. X is to avoid other MI. What measures should be included in such a discussion? tages. However pensated shock ARDS or DIC

Answer 1

1. The high risk factors are

• Family history
• Smoker
• Fast food
• Stress
• Decrease in activities

2.Atherosclerosis refers to the deposition of plaque or cholesterol along the pathway of the blood vessels.This narrows the blood vessels leading to decrease in blood supply to the cardiac muscle or a complete block by the cholesterol in the pathway can cease blood supply to the cardiac muscle.This lack of blood supply leads to lack of oxygen to the cardiac tissue and causing ischemia and death of cells called as myocardial infarction.

3. The pain occurs when the blood supply is deprived to heart muscles injuring the blood vessels causing cell death and acute pain which is called as angina

4. The admitting signs are

• Fatigue
• Anxious
• Cool and clammy facial skin
• Leg pain