Week 4 Cardiovascular Case Study

Case Study

The diagnosis which is consistent with John’s history and physical exam is by use of Electrocardiogram test (ECG). The ECG is used to record electrical signal which triggers heartbeat. The physician looks among these heartbeats to check if blood flow through the heart is interrupted, slowed or if the patient is having a heart attack (Ramirez, Nedley & Sanchez, 2017). The physician can also attach patches of ECG on arms, legs, and chest to monitor if the patient has high blood pressure. ST-Elevation Myocardial Infarction or STEMI is a serious heart attack which occurs when one of the heart’s primary arteries gets blocked. A STEMI attack poses a significant risk of disability and death. On the other hand, non-STEMI heart attack involves a partial blockage of an artery which severely reduces blood flow. 

    The pathophysiological findings which specify myocardial infarction (MI) include the sudden ischemic death of myocardial tissue. The MI results from thrombotic blocking of a coronary vessel resulting from rupture of a vulnerable plaque. Ischemia triggers profound ionic and metabolic alarms in the affected heart tissue and results in rapid depression of systematic function (Finkle et al. 2014).

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    Angina is described as chest discomfort or pain which occurs when the heart muscle does not get enough oxygenated blood. This condition is known as cardiac ischemia which is characterized by decreased flow oxygenated to the myocardium. If ischemia is severe or lasts for a long time, it can cause a heart attack and death of heart tissue. Individuals may have ischemia without pain a condition known as silent ischemia. These individuals may develop heart attack without prior warning. On the other hand, myocardial ischemia occurs when blood flow to the heart muscle is occluded by partial or complete obstruction of a coronary artery by atherosclerosis. These individuals are at risk of developing a heart attack (Ramirez, Nedley & Sanchez, 2017).

    Sudden cardiac death is associated with various factors including coronary artery disease, previous heart attack and family history of sudden cardiac arrest. About 80% of sudden cardiac death is linked with coronary artery disease. An individual’s risk of sudden cardiac death is higher during the first six months after a heart attack. Also, an individual family history can predispose an individual to get a sudden cardiac death (Finkel et al. 2014). The possible complications post-MI which the nurse practitioner should be aware of when caring for John include infarct extension, cardiogenic shock, aneurysms, and heart failure.     

References

1. Finkle, W. D., et al. (2014). Increased risk of non-fatal myocardial infarction following testosterone therapy prescription in men. PloS one, 9(1), e85805.
2. Ramirez, F. E., Nedley, N., and Sanchez, A. (2017). Angina Patients Improve Physical Fitness in 18 Days.