1. What is the medical problem that your patient is most likely presenting with?
759. Mr. Miller is likely presenting with an acute myocardial infarction. Based on his past medical history of hypertension, hyperlipidemia, obesity, and diabetes, along with his current symptoms of chest pain, shortness of breath, pale skin with beads of sweat on the forehead, as well as elevated lab 's Troponin, CK, and CK-MB, he is most likely presenting with an acute myocardial infarction.
2. What is the underlying cause /pathophysiology of this concern?
Myocardial infarctions are caused by vascular endothelial disruption most often associated with plaque build-up or atherosclerosis that develops over several years and causes thrombus formation which in turn
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Hyperlipidemia or increased cholesterol builds up causing narrowing in the arteries, which reduces oxygen rich blood flow to the heart and tissues, also increasing the risk for myocardial infarction. Obesity increases the risk of developing diabetes, high blood pressure, and hyperlipidemia, increasing the risk of atherosclerosis, and therefore increasing the risk of myocardial infarction.
3. Based on the data you have collected, what is your primary concern right now?
The primary concern for Mr. Miller would be preventing further ischemia and necrosis of the myocardial tissues, preventing serious complications such as cardiac dysrhythmias and heart failure, as well as relieving his chest pain that radiates to his left arm. Preventing further ischemia and necrosis of the myocardial tissue will help prevent the development of heart failure due to myocardial infarction, whereas relieving his pain will help reduce his episodes of shortness of breath, and will also help to reduce any anxiety and restlessness he may be having from being in pain and short of breath.
4. What interventions will you initiate based on this primary concern? (start with A·B·C
Being overweight or obese are risk factors for many chronic health conditions such as heart disease, diabetes, and … cancers.”
Myocardial Infarction Introduction A myocardial infarction or heart attack, is the death or damage of part of the heart muscle because the supply of blood to the heart is severely reduced or stopped. Myocardial infarction (MI) is the leading cause of death in the United States. More than 1.5 million Americans suffer a myocardial infarction every year, and nearly half a million die, according to the American Heart Association. Most myocardial infarctions are the end result of years of silent, undetected, progressive coronary artery disease. Causes: One of the most common causes of heart attack is coronary artery disease, where coronary arteries become hardened and narrowed due to atherosclerosis.
Coronary heart disease is defined by the hardening of the epicardial coronary arteries. The buildup of plaque in the arteries slowly narrows the coronary artery lumen. In order to better understand the physiology of the disease, it is important to first know the basic anatomy of the human heart. The aorta, located in the superior region of the heart, branches off into two main coronary blood vessels, otherwise known as arteries. The arteries are located on the left and right side of the heart and span its surface. They subsequently branch off into smaller arteries which supply oxygen-rich blood to the entire heart (Texas Heart Institute, 2013). Therefore, the narrowing of these arteries due to plaque buildup significantly impairs blood flow throughout the heart.
2. Hypertension. Adequate control given illness. We do not want his pressure to run too low.
A myocardial infarction occurs when blood supply to the heart is limited or stopped because of blockage in a coronary artery. Narrowing of coronary arteries as a result of artherosclerotic plaque buildup “causes more than 90% of heart attacks” (Heart and Stroke Foundation of Canada, 2011). As plaque builds up in the arteries, there is an increased chance that the plaque will rupture and cause a bleed that, subsequently, clots (thrombus). Ischemia (reduced blood flow to tissues) to the tissue the coronary artery supplies with become damaged and, with long enough occlusion, die (American Heart Association, 2012).
Ischemic heart disease (IHD) refers to dysfunction of the left ventricle as a result of insufficient delivery of oxygen to the myocardium, which can occur due to coronary artery disease (CAD) (Cassar et al., 2009). If it is severe and sustained will lead to irreversible myocardial cell damage and infarction of the myocardium (Cassar et al., 2009). CAD is the most frequent cause of IHD in which deposition of atherosclerotic plaque overtime results in stenosis inside the artery and reduced blood flow to the heart or a rupture of an atherosclerotic plaque in a coronary artery can occur leading to thrombus formation in that artery (Koulaouzidis, 2013). The subendocardium is most vulnerable to ischemia and the infarct may expand to the subepicardium
His blood glucose level indicated 10mmol/L. Mr Harry Bright was evaluated with PQRST assessment and was administered sublingual nitro-glycerine spray and morphine for his chest pain. The quality of his pain is in his chest and the region of pain was radiating down his arm and jaws. The pain started at 4 or 5 minutes after the nursing handover and the severity of the pain was 6 out of 10. During his episode of chest pain, the medical officer was contacted to inform his chest pain and to confirm his medication prescribed. Then, the patient mentioned pain in his right groin where neurovascular observation was performed. The affect limb appeared pallor, polar, paraesthesia, and pulselessness and the patient stated numb, pin and needle sensation. The patient was repositioned with his head of bed elevation below 30 degrees due to discomfort and his metformin tablet was not administered. His puncture site have only minimal amount of oozing, no swelling or haematoma. My only concerns is that he may have an occlusion vessel in his limb based on the observation and assessment
Myocardial infarct causes structural damage to the visceral and the parietal pericardium as the smooth lubricated surfaces are no more so the friction free movement of the heart is weakened or diminished. As the heart failure occurs, the myofibroblasts are found in large amounts in the heart as they produce cytokines which helps maintain the inflammatory response to injury. (Baum) During myocardial infarction, Purkinje fibers and other parts of the conducting system are damaged due to a lack of oxygen when the arterial supply is no more.
Mr. Turner, a 72-year-old retired trucker, just arrived at the ED complaining of just not feeling right for the last 2 weeks but today is much worse. He has not been feeling well for about 2 weeks. He has noticed increasing dyspnea on exertion and has been having trouble
About 600,000 people in the United States have died from heart disease every year. Unfortunately, my parent’s fathers have died from this horrible disease. My father suffers with this disease and had a heart attack three years ago this is why I have decided to understand and learn more about Coronary Artery Disease. This disease has been in my family for three generations. The main reason why this occurred in my family was the unhealthy foods they were consuming along with stress. These were the factors that interrupted the distribution of blood to the heart or damaged the heart muscle to pump the blood to the heart, causing the death of both my grandfathers. Throughout my report, I will explain in detail the causes of the disease, the symptoms and characteristics, a possible cure or treatment for the disease and finally, the effect on the lifestyle of those affected and the family members.
Myocardial infarction and stroke are both very destructive to the human body especially in terms of possible organ and tissue damage. This essay will discuss topics involving MI and stroke and various treatments, risk factors, causes, and other items surround the two.
I am comparing the information given about Heart attack (Acute myocardial infarction) on two websites Web MD and The U.S. National Library of Medicine. Web MD is aimed more to cater to the general public with limited knowledge basic, this website allows you to view information at a level at which most people regardless of their age would be able to comprehend. I do feel the information presented on this website might be a challenge for someone with limited education or who doesn’t have at least eighth grade reading skills. The secondary audience for Web MD might be a healthcare professional looking for a quick limited resource. One of the persuasive strategies use to appeal to their primary audience are pictures and content organization in
Coronary artery disease (CAD) is caused by reduced blood flow in the coronary arteries. This subsequently leads to reduced oxygenation to the myocardium, resulting in transient ischemia or angina. CAD may cause permanent damage to myocardial cells or infarction. The left ventricle of the heart is most susceptible to CAD.
A myocardial infarction occurs when the coronary arteries become blocked. This blockage leads to decreased oxygenated blood flow to the heart muscle. The blockage is typically caused by a buildup of atherosclerotic plaque on the inside lining of the coronary arteries (What). If this plaque ruptures then a myocardial infarction will take place. When the plaque ruptures the immune system begins to respond by sending platelets to fight it. The problem here is that the platelets are sticky and they clot together. When platelets reach the site of the rupture they attach to it and make a blood clot. This decreases the open diameter of the coronary artery and causes less blood to reach the heart muscle. The heart muscle following
With obesity can come many other diseases or health problems. For example, people who are obese are more likely to develop heart problems, diabetes, or high blood pressure (Loop).... ... middle of paper ... ...