M.T. is a 72-year-old woman, who is transported by ambulance to the hospital, with dizziness, fainting,...
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.
How could you determine if the infarction is in a left versus right coronary artery?
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M.T. is a 72-year-old woman, who is transported by ambulance to
the hospital, with dizziness, fainting,...
Case Study M.T. is a 72-year-old woman, who is transported by ambulance to the hospital, with...
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...
Dysrhythmia Workup Patient Profile D.B. is a 61-year-old female present to the emergency department after fainting...
Dysrhythmia Workup Patient Profile D.B. is a 61-year-old female present to the emergency department after fainting in the grocery store. She has a history of gastroesophageal reflux disease and hypertension. She is currently taking the following medications: omeprazole 20 mg PO daily before breakfast captopril 50 mg PO twice daily Subjective Data States that all she remembers is that she was grocery shopping and felt some palpitations in her chest, shortness of breath, and dizziness. The next thing she knew,...
A 52-year old woman was admitted to the hospital because of several episodes of dizziness and...
A 52-year old woman was admitted to the hospital because of several episodes of dizziness and lightheadedness that caused her to occasionally fall. These episodes were associated with palpitations and diaphoresis. The symptoms would improve when she sat down. Her heart rate was often very rapid (> 120 beats per minute) when she would stand. She had a history of hypertension and occasional atrial fibrillation (she is normally in sinus rhythm though). Upon being admitted to the hospital she was...
Mrs. T., a 74-year-old white woman, drove herself to the emergency department, arriving at 10:30 AM....
Mrs. T., a 74-year-old white woman, drove herself to the emergency department, arriving at 10:30 AM. She complained of substernal chest pain with radiation to her back that began 1 hour ago. The pain is not relieved by rest or one sublingual nitroglycerin. She describes the pain as dull and rates it a 7 on a scale of 10. She feels nauseated but has not vomited. Mrs. T. has a history of hypertension, diabetes, and elevated cholesterol levels. She has...
C3. 3. Mrs. Muller is a 78-year-old homemaker who arrives in the emergency department with a...
C3. 3. Mrs. Muller is a 78-year-old homemaker who arrives in the emergency department with a history of chest discomfort and indigestion two days ago that lasted about 12 hours. She was severely fatigued after this and within the past 2 hours has become increasingly short of breath, Her initial ECG shows that she recently experienced an anterior AMI. Her skin is cold, and she is very diaphoretic and cyanotic. She is diagnosed with acute heart failure and cardiogenic shock....
Case study Jane is a 38 year old woman who recently was told by her doctor...
Case study Jane is a 38 year old woman who recently was told by her doctor that she is “pre-diabetic” and her blood pressure is 130/82. Jane is 5 feet, 5 inches tall (5’5”) and weighs 200 lbs. Her waist circumference is 38 inches. Jane’s total cholesterol is 250, her HDL is 35, and her LDL is 162. Jane’s father died of a heart attack last year. Jane does not currently participate in an exercise program, but she does walk 10 minutes every day...
While walking to work, Mio has a sudden onset of dizziness and feels faint. In addition,...
While walking to work, Mio has a sudden onset of dizziness and
feels faint. In addition, she experiences diaphoresis (excessive
sweating) and palpitations (rapid, fluttering heart). When she
arrives at her office, her concerned colleagues call an
ambulance.
In the emergency department, the nurse and doctor make the
following notes in Mio’s record:
55-year-old female, blood pressure = 162/110 mm Hg, on
metoprolol, furosemide, propafenone.
Blood pressure dropped upon standing to 102/65 mmHg, and
palpitations were observed.
After receiving a...
Ms. X is a 30-year old African American female who presented to the ED with a...
Ms. X is a 30-year old African American female who presented to the ED with a complaint of body aches. She reports generalized body aches and joint pains. The pain is constant, throbbing in nature and is a 10 out of 10 in severity. The pain has been ongoing for the last week and has progressively gotten worse. She was seen in the ED 5 days ago, given pain medication and discharged. She has had profuse diarrhea and fevers for...
Hilda Wilde is a 45-year-old woman who was diagnosed with asthma as a child. She recalls...
Hilda Wilde is a 45-year-old woman who was diagnosed with asthma as a child. She recalls her first asthma attack being horrendous; chest tightness, difficulty breathing, wheezing, feeling anxious and sweating profusely. She was rushed to hospital and spent many days in hospital as a child until she managed to work out the triggers and control it early. The triggers for her asthma were cold temperatures, pollen, smoky environments and respiratory infections/colds, which continue to be the triggers throughout her...
A 48-year-old woman presented to the Emergency Department with nausea, dizziness, and easy fatigability. She...
A 48-year-old woman presented to the Emergency Department with nausea, dizziness, and easy fatigability. She also complained of decreased appetite and unintentional weight loss of 16 kg over the last 10 months. Upon further examination pt. was also noted to have increasing darkening of the skin around the face and upper back. Pt. denied any headaches, blurry vision, loss of consciousness, and/or change in her bowel habits. Pt. history includes Tuberculosis (when she was a child) Surgical History: C-Section...
C3. 3. Mrs. Muller is a 78-year-old homemaker who arrives in the emergency department with a history of chest discomfort and indigestion two days ago that lasted about 12 hours. She was severely fatigued after this and within the past 2 hours has become increasingly short of breath, Her initial ECG shows that she recently experienced an anterior AMI. Her skin is cold, and she is very diaphoretic and cyanotic. She is diagnosed with acute heart failure and cardiogenic shock....
While walking to work, Mio has a sudden onset of dizziness and
feels faint. In addition, she experiences diaphoresis (excessive
sweating) and palpitations (rapid, fluttering heart). When she
arrives at her office, her concerned colleagues call an
ambulance.
In the emergency department, the nurse and doctor make the
following notes in Mio’s record:
55-year-old female, blood pressure = 162/110 mm Hg, on
metoprolol, furosemide, propafenone.
Blood pressure dropped upon standing to 102/65 mmHg, and
palpitations were observed.
After receiving a...
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