Exam (elaborations) Cardiovascular_case_study

Zaina Aoun Madonna University Saturday September 21, 2023 Cardiovascular case study Mr. M is a 59-year-old male who presents to the emergency department with complains of tight chest pressure, jaw pain and left arm numbness and tingling. He also had shortness of breath after lifting several boxes in his garage approximately 2 hours ago. Mr. M thinks that his heart is skipping beats. His medical history is significant for hypertension hyperlipidemia is a cigarette smoker and leads a sedentary life style. On examination, his B/P is 155/95 and heart rate is 55 beats/min and regular, and his lungs are clear to auscultation. An electrocardiogram shows bradycardia with an increased PR interval and ST-segment elevation in multiple leads including the anterior leads, V3, V4. The patient also reports becoming diaphoretic during the event however denies nausea, vomiting, dizziness, syncope or near syncope. He also reports never experiencing these symptoms in the past. Mr. M current medication include Amlodipine 10mg daily and Atorvastatin 20mg daily. He has smoked 1 PPD for 25 years, consumes 2 beers per week, denies drug use. Both of his parents passed way in their early 60s from coronary artery disease. His father died at 61 yoa from an MI and mother at 63 yoa from the complications of congestive heart failure. Given the above information answer the questions below. Questions 1. What is the most likely diagnosis for this patient? a. According to the information given above, the most likely diagnosis would be a Myocardial infarction. An MI is an area of the myocardium that is permanently destroyed. This is caused by reduced blood flow in a coronary artery due to rupture of an atherosclerotic plaque and subsequent occlusion of the artery by a thrombus (a blood clot formed within a blood vessel). There are various descriptions used to further identify the type of MI present. In this case, Mr. M’s electrocardiogram indicated an ST-segment elevation further indicates that this is a ST-segment elevation MI (STEMI) (Honan, 420). 2. What are the most common causes of this disease? Which is the most likely in this patient? a. A myocardial infarction can have many underlying causes which includes, when a spasm of the coronary artery leads to constriction and shutting down of blood flow to an area of the heart muscle this can occur due to the use of tobacco and in Mr. M’s case he indicated he has smoked 1 PPD for 25 years which could be a cause that lead to his diagnosis of an MI. Another common cause for this disease is hyperlipidemia which is an elevated cholesterol level, this can cause the coronary artery to become narrow and reduce blood flow to heart muscle also