Question

Peter is a 52-year-old patient that presented to the emergency room with chest pain. He was shoveling snow when he became short of breath and dizzy. He experienced chest pain that he described as “heavy” and “crushing”. The pain radiated to his jaw and back.  

After the symptoms began, he stopped working, went into his house and rested. The pain did not subside after 15 minutes so he decided to seek care. He is very anxious and shares that his father passed away at the age of 53 from a heart attack.

The patient’s medical history includes hypertension, hyperlipidemia, and diabetes (type 2). He does not follow a heart healthy diet or a diabetic diet. His BMI is 32. He has a 10 year history of smoking but quit 10 months ago.  

Upon assessment, his heart rate is 118, his blood pressure is 172/96, and his respirations are 22. His pain is currently rated a 6/10 over his left chest. He states is pain did improve after the administration of nitroglycerin. He remains somewhat short of breath and is on 2L oxygen per NC. His lungs are clear to auscultation. His skin is cool, clammy, and pale. The rest of your assessment is pending.  

1. Do you believe the patient is experiencing chest pain due to a cardiac event? Support your answer.

2. Does the patient have any cardiac risk factors? If so, describe them.  

3. What other assessments would you complete at this time for this patient?

4. What other things (diseases, events, etc.) can cause pain over the chest? How would you differentiate this causes of pain from a cardiac event?

Answer 1

The above scenario of peter reveals his health history.he is 52 years old having hypertension,Hyperlipidemia and type 2 diabetes.after reading the above scenario it is confirmed that peter was having a acute myocardial infraction.acute MI often associated with a heavy and crushing chest pain radiating to the back and jaw,dizziness and dyspnea.peter had these symptoms exactly.

The patient has cardiac risk factors such as he has a history of hypertension which a leading predisposing factor for cardiac attack.acute MI is caused by the blockage of heart.high lipid in blood and type 2 diabetes are also can be listed as risk factors for cardiac factor.

After physical examination we will do electrocardiogram.among blood tests trop t should be done immediately within 3-6 hours of attack.other than that creatine kinase mb test can be done.elevated trop t value indicate intensity of heart attack.

Any person can have chest pain.chest pain is not always caused by decreased blood flow of the heart.it can be caused by gastro related problem also.we can differentiate it by the nature of pain.for MI patients they will feel a pricking pain which will radiate to the jaw and back on the left side and it will not disappear after nitroglycerin administration.