Case Study of Mr. Papas

Running head: CASE STUDY OF Mr. PAPAS
CASE STUDY OF Mr. PAPAS
Name of the student:
Name of the university:
Author note:

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CASE STUDY OF Mr. PAPAS
Risk factors and health promotion:
Myocardial infarction can be described as the disorder where blood flow to the heart gets
reduced or even may get stopped that results in occurrence of damage in the heart muscles. One
of the risk factor of the disorder which promotes the vulnerability of an individual to develop the
disorder is smoking of tobacco. It has been found that chemicals that are present in the cigarette
smokes contribute to swelling of the cells that are present in the lining of the blood vessels
(Anderson et al., 2017). They are seen to become inflamed which actually causes narrowing of
the blood vessels and this results in development of various types of heart ailments. Studies have
found that cigarette smoking results in development of plaques in the arteries which obstructs the
flow of the blood in the blood vessels. Moreover, the arteries are seen to lose their flexibility and
the opening of the arteries also become narrow resulting in situations called atherosclerosis.
Blood faces obstacles to flow through these damaged blood vessels and hence blood flow to the
heart gets obstructed. Many researchers are also of the opinion that smoking causes the blood to
be thicker making them more prone to develop clots inside the veins and arteries which also
block the blood flow to the heart. In this way, myocardial infarctions take place from smoking
(Reed et al., 2017). Mr Papas is seen to smoke around 15 cigarettes which might have been one
of the main risk factor that had resulted in myocardial infarction in the patient. Another risk
factor that contributes to myocardial infarction is sedentary lifestyle as well as lack of physical
activities and exercises in the life. It has been found in studies that exercise contributes in
keeping the heart healthy and helps to maintain the blood pressure level in the individuals
thereby preventing occurrence of heart disorders. Exercises also contribute to healthy body
weight and prevent the development of obesity that increases the chance of developing AMI. It
was seen Mr. Papas was an It professional who mainly used to work indoors and always seemed

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CASE STUDY OF Mr. PAPAS
to be so busy that he could rarely undertake any physical activities as well as exercises (Li et al.,
2015). The sedentary lifestyle of the patient might have been one of the contributor or the risk
factor that had made him vulnerable to develop AMI. It is extremely important for the nursing
professionals to develop health literacy of the patient. Developing his health literacy would help
him to understand how his lifestyle choices and health behaviors are contributing to the disorder
that he had developed. He has already been of the opinion that his lifestyle choices had been the
main reason of the development of AMI. The nursing professionals may refer Mr. Papas to a
substance abuse counselor who can undertake cognitive behavioral therapy and help him to
unlearn the behavior of smoking. She can also refer her to anti-smoking workshops held by many
healthcare agencies in the community which Mr. Papas can attend to for overcoming his
smoking issues. The nurse should also educate him about the importance of exercises and other
physical activities for prevention of the recurrence of the disorder (Ibanez et al., 2017). The nurse
can also develop an exercise regime that aligns with his age and present health condition without
creating extra stress on him. Mr. papas should be also educated about the importance of regular
screening which can help him to understand whether he is out of danger or not for developing
any chronic disorders. A diet chart should also be given to him so that chances of developing
obesity or becoming overweight reduces and in turn chances of heart disorders.
Pathophysiology:
Often atherosclerosis procedure results in development of “vulnerable plaque” which
become responsible for acute coronary syndromes and ultimately, coronary artery thrombosis
become the end point. These are the situations that are found to be mimicking STEMI and
distinguishing them becomes very difficult. A substance known as the tissue factor remains
located within the necrotic core of the plaques. When such substances get exploded in the blood

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CASE STUDY OF Mr. PAPAS
stream, tissue factors are seen to activate the clotting cascades thereby resulting in the occurrence
of the thrombosis (Niccoli et al., 2015). Studies opine that tissue factors might get exposed when
the fibrous cap which is seen to cover the plaque gets ulcerated or disrupted and this disruption
of the fibrous cap results in the plaque erosion or plaque rupture. Surprisingly plaque rupture is
seen to occur at the site of the modest coronary stenosis and therefore even if stress testing
becomes normal, the risk of the acute coronary syndrome still remains present. STEMI mainly
results from the coronary thrombosis after plaque rupture takes place and less often from fixed
obstruction (Mehta et al., 2016). Unstable angina is found to have much lower incidence of the
coronary thrombosis as compared to NSTEMI or STEMI and is often seen to take place from
fixed atherosclerotic stenosis. Studies opine that plaque rupture most commonly and are some
cases plaque erosion result in coronary occlusion which is the main predominant mechanism of
STEMI and NSTEMI.
A ST elevation myocardial infarction mainly occurs as a result of the thrombus formation
and this aspect results in the complete occlusion of the major epicardial coronary vessel. STEMI
is considered to be one of the most severe forms of acute syndromes and is found to be life-
threatening. This is a time-sensitive emergency that must be immediately treated with the help if
coronary revsacularisation as well as through percutaneous coronary interventions. Unlike that of
the non ST segment elevation as well as through unstable angina, STEMI mainly shows a
significant ST elevation in the 12 lead ECG (Cequier et al., 2017). A Non-ST segment elevation
is found to be different from ST segment elevation on particular aspects. In the former one,
angina symptoms at rest that mainly contribute to myocardial necrosis can be identified by the
elevated cardiac biomarkers showing no ST segment elevation on the 12-lead electrocardiogram.
But, the latter mainly comprises of angina symptoms at rest that contributes myocardial necrosis