Question

Case Study

M.T. is a 72-year-old woman, who is transported by ambulance to the hospital, with dizziness, fainting, weakness, fatigue, nausea, sweating, shortness of breath, and indigestion (heart burn) pain. These symptoms began about 2 hours ago and have become progressively worse since arriving at the hospital. Blood pressure is 200/100; pulse is 102 and regular. Lung sounds are clear. No murmur is noted on cardiac auscultation. Her ECG and cardiac enzyme levels are indicative of myocardial infarction. Her past history is significant for smoking 20 years. She did quit about 5 years ago. She says she has “always” had a high cholesterol level and she was told about 10 years ago that she was a “borderline diabetic.” Her mother had a “heart attack” at age 62. She is currently on a cholesterol reducing drug and an antihypertensive drug. She does take these medications daily.

1. What are M.T.’s risk factors?

2. How could you determine if the infarction is in a left versus right coronary artery?

3. What is the significance of having elevated cardiac enzymes?

4. What factors will impact her prognosis?

Answer 1

1)Risk factors

• Age
• Family history
• Untreated borderline diabetes
• Hypertension
• Hyperlipedimia
• Smoking history

2) The patient has myocardial infarction at left coronary artery system because it is the major blood supply provider. Any injury will always affect it first.

3)The importance if elevated cardiac enzymes gives is a confirmation of time and level of injury to the heart muscle

4)Her age,medical condition will have a impact in her prognosis.