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 for the disorder and health promotion:
Acute myocardial infarction results in an emergency and life threatening situation for a
patient where the blood flow to the heart gets reduced and even might get stopped. Lack of blood
flow results in damaging the muscles of the heart resulting in heart failures. Researchers have
associated smoking as one of the risk factors that increase the chance of the person to develop
this disorder (Anderson & Morrow, 2017). Smoking is seen to contribute in the development of
plaques in the arteries and prevents the smooth flow of blood through the arteries. The arteries
become less flexible and their openings also narrow down in such ways that blood faces
obstruction to flow through them. Many other studies are of the opinion that chemicals that are
found in the cigarette smokes make the cells lining the arteries to get swollen. These cells
undergo inflammation and this contributes to the development of narrow passage for the blood in
the arteries reducing the diameter of the blood vessels and making it harder for the blood to flow
through the vessels to the heart (Cequier et al., 2017). Therefore, smoking is seen to contribute in
the obstruction of blood flow to the heart for which oxygen do not get supplied to heart muscle
making them gradually damaged. Many of the researchers are also of the opinion that smoking
causes thickening of the blood that result in development of blood clots inside the veins as well
as the arteries obstructing blood flow to the heart. Mr. Papas has been found to be smoking 15
cigarettes per day which thereby makes him more prone to the development of the conditions
like acute myocardial infarctions (Defteroes et al., 2015). Another risk factor that also
contributes to the development of AMI in the patient is his sedentary lifestyle. He is an IT
professional who remains busy throughout the day in the office and rarely gets the scope of
conducting physical exercise. Lack of exercises acts as one of the risk factors that contribute to
development of acute myocardial infarctions. Exercises are seen to help individuals in living a

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CASE STUDY OF MR. PAPAS
fitter life and also keep the blood pressure level under control. Exercises are also seen to be
intricately associated maintaining a fitter and healthier body weight that prevents obesity and
overweight issues which also contribute to heart disorders. Mr. Papas had been found to live
sedentary lives where his work pressure might have not allowed him enough time to undertake
exercises for himself. Another possibility might be that he has low health literacy for which he
might have not been able to understand the importance of engaging in physical activities and
exercise and maintaining healthy diets (Engstrom et al., 2015). He nursing professional should
first try to develop the health literacy of Mr. Papas so that he can identify the specific actions and
lifestyle choices which might have contributed to the occurrence of AMI. Advices on stopping
smoking, changing the dietary patterns and also undertaking exercises and physical activities are
the three main domains on which the nurses should educate the patient. Following this, the nurse
could also refer the patient to the healthcare agencies who conduct smoking cessation programs
which would help the patient to overcome the habit of smoking. The nurse can also collaborate
with substance abuse counselors and help the patient with cognitive behavioral therapies to help
him modify his smoking behaviors.
Pathophysiology:
A ST elevation myocardial infarction is called the STEMI. This is mainly seen to take
place because of the formation of thrombus that contributes in occluding the main epicardeal
coronary vessels completely. STEMI is considered to be one of the most acute syndromes
resulting in life threatening heart conditions in individuals. Studies opine that such symptoms
need to be treated with various interventions of coronary revascularization and also through that
of the percutaneous coronary interventions (Goldsweig et al., 2018). Researchers are of the
opinion that atherosclerosis can be one of the main concerning factor that causes development of

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CASE STUDY OF MR. PAPAS
the situation of vulnerable plaque. This plaque becomes the main contributing factor that causes
acute coronary syndromes and ultimately coronary artery thrombosis is seen to take place. These
conditions mainly mimic the STEMI and distinguishing them becomes very critical. Studies have
stated that a substance namely tissue factor remains located in mainly in the necrotic core of the
plaques. At the particular time, when such substances are found to get burst in the bloodstream,
the clotting cascades get activated (Levine et al., 2016). This causes development of thrombosis.
The fibrous cap that covers the plaque might undergo ulceration or that of disruption mainly
expose the tissue factors resulting in the plaque erosion or that of the plaque rupture. Mannverk
et al. (2019) had been of the opinion that plaque rupture astonishingly takes place in the site of
the modest coronary stenosis and therefore even if stress testing becomes normal, the risk of the
cause coronary syndromes remain present. The occurrence of STEMI is mainly because of the
result of coronary thrombosis after rupturing of the plaque and less often from the fixed
obstruction. Comparative studies have revealed that unstable angina has much lower level
incidences of the occurrence of coronary thrombosis to that of the NSTEMI as well as STEMI
and mainly takes place from situations like fixed atherosclerotic stenosis. Rupturing and erosion
of the plaques contribute to coronary occlusion and is the main predominant mechanism of
STEMI and NTSEMI (Niccoli et al., 2015). Unlike that of unstable angina and that of the non ST
segment elevation (NSTEMI), STEMI is seen to show a marked elevation of the ST segment in
particular aspects. It has been found in case of STEMI, angina symptoms are seen to take place
which contributes myocardial necrosis and can be characterized by the elevated levels of
different cardiac markers along with that of the elevation of ST segment on that of the 12-lead
electrocardiogram. In case of the N-STEMI, it is seen that angina symptoms are seen to occur