Question

4. Your completed work should be submitted to your lecture instructor on time by the due date indicated on the syllabus. History of Present Illness H.J. presented to the emergency department (ED) late one evening complaining of a "racing heartbeat". She is an overweight, 69-year-old white female, who has been experiencing increasing shortness of breath for the past two months and marked swelling of the ankles and feet for the past three weeks. She feels very weak and tired most of the time and has recently been waking up in the middle of the night with severe breathing problems. She has been sleeping with several pillows to keep herself propped up. Five years ago, she suffered an anterior wall (left ventricle) myocardial infarction (MI). She received coronary artery bypass surgery 4 12 years ago for obstructions in the left anterior descending and left circumflex coronary arteries. The patient is admitted to the hospital for a thorough examination.

Answer 1

2. It is a case of Diastolic Heart Failure because the symptoms are caused due to reduced amount of blood pumped out to the body and it occurs because left lower chamber does not fill properly during diastolic phase . Symptoms are :-

Awakening at night with shortness of breath.

Breathlessness or shortness of breath during exercise or when lying flat.

Coughing or wheezing, sometimes with white or pink phlegm.

Difficulty concentrating.

Fatigue.

Fluid retention causing swelling in the ankles, legs, feet and/or abdomen.

11. Hypokalemia is often caused by nonpotassium-sparing diuretics, insufficient potassium intake and a shift of potassium into stores by increased potassium uptake stimulated by catecholamines, beta-adrenoceptor agonists and insulin.

High intake of salt, inappropriate lack of thirst with poor cardiac functionings results in hypernatremia.