Question

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Cardiovascular case study

Ms. X., aged 55 years, 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 clammy; her blood pressure is 90/60, and the pulse is around 90, weak, and irregular. She is given oxygen, an intravenous line is opened, and leads for ECG are attached. Blood is taken for determination of serum enzymes and electrolytes. Tentative diagnosis is myocardial infarction involving the left ventricle. Her son provides information that indicates Ms. X is a long-time smoker, has a stressful job as a high school teacher, is recently separated 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 to rely on "fast foods" like pizza 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 walking or climbing stairs at work. Generalized atherosclerosis is suspected.

Question:

. What is "atypical" in Ms. X's symptoms? How does this affect treatment and prognosis?

Answer 1

What is "atypical" in Ms. X's symptoms?

• Weariness because of weakened blood supply to various body parts. This is caused because of inappropriate working of the heart.
• Cool and damp skin because of deficient blood stream
• Hypotension and unpredictable heartbeat
• Leg pain due to inadewuate blood supply to the peripheral arteries of legs and hands.
• Chest pain (angina) due to impaired blood flow to heart.

How does this affect treatment and prognosis?

Myocardial infarction is defined as the death of cardiac muscle cells due to absence of or deficit blood supply to the heart muscle.

Atherosclerosis is characterized as entire or fractional impediment of a vein caused because of arrangement of plaque in the vein.

The impediment of a corridor results in entire blockage or narrowing of the conduit upsetting the blood supply to the heart. This outcomes in absence of oxygen supply to the heart causing demise of myocardial tissue. This is the way atherosclerosis causes myocardial localized necrosis.