Question

Ms. X, 55 years old, has been complaining of severe fatigue and indigestion. Her son is quite concerned and decides to take her to the emergency department. On arrival, she appears very anxious, and her facial skin is cool and clamy; her blood pressure is 90/60, and her pulse is weak and irregular at 90. She is giving oxygen, an IV line is opened, and ECG is hooked up. Blood is taken for determination of serum enzymes and electrolytes. Tenative diagnosis is myocardial infarction involving the left ventricle. Her son provides information that indicates she is a long time smoker, stressful job as a teach, and recently seperated after 20 years of marriage, and is fearful of losing the family home. She has also seemed to be more fatigued and stopped going to the gym about 18 months ago. She has begun eating "fast foods", like pizza and fried chicken. Her father died of a heart attack at age 50. She has also noticed more fatigue and intermittent leg pain when walking and climbing stairs at work. Generalized atherosclerosis in suspected. PVC's are revealed.

1. What are the risk factors in this patient's histor for atherosclerosis?

2. How does atherosclerosis cause a myocardial infarction?

3. Name 2 serum enzymes that may have been tested to diagnose a MI.

4. What are PVC's?

5. What causes PVC's?

What type of medications are the following? What do each of them do?

1. Nitroglycerin

2. Metaprolol

3. Digoxin

4. Altace

5. Warfarin

6. Aspirin

Answer 1

Ans) 1) Atherosclerosis typically affects those with poor lifestyle habits and medical conditions, such as high cholesterol, high blood pressure (hypertension) or diabetes. A family history of heart disease also puts you at a higher risk of developing atherosclerosis, which usually affects men over 50 and women over 60.

2) In the brain, this causes a stroke; in the heart, a heart attack.

- The plaques of atherosclerosis cause the three main kinds of cardiovascular disease: Coronary artery disease : Stable plaques in the heart's arteries cause angina (chest pain).

- A sudden plaque rupture and clotting cause heart muscle to die.

3) Creatine Phosphokinase (CPK or CK):

CPK catalyzes the reversible transfer of phosphate groups between creatine and phosphocreatine as well as between ATP and ADP. Most of the CPK resides in skeletal muscle, heart muscle, and in the gastrointestinal tract.

Lactic Dehydrogenase (LDH):

The LDH isoenzymes test assists in differentiating heart attack, anemia, lung injury, or liver disease from other conditions that may cause the same symptoms.

4) Premature ventricular contractions (PVCs) are extra heartbeats that begin in one of heart's two lower pumping chambers (ventricles). These extra beats disrupt the regular heart rhythm, sometimes causing to feel a fluttering or a skipped beat in the chest.