Chronic Illness: Risk Factors and Health Services in Australia

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CHRONIC ILLNESS
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CHRONIC ILLNESS 2
Introduction
This is a case study on patient Liz who is Forty-nine years old, weighs 87 kgs, is 165 cm
high. She was diagnosed with chronic bronchitis five years ago. Since then she has been trying to
cut down her cigarette smoking. At the moment she smokes 3 sticks daily. In addition to this, she
occasionally drinks. She exercises by walking their dog for fifteen minutes around the
neighborhood. Her cholesterol is high and she has ongoing hypertension and she is on anti-
hypertensive medication. Patient Liz has recently relocated so as to avoid domestic violence
from her partner. She lives with her son who is 22 years old and is a cook. To support him she
started driving an uber. She was admitted three days ago after she suddenly got dizzy and right-
sided weakness for over 6 hours. While in the emergency department she underwent a CT scan,
blood tests and ECG that showed that she had an atrial fibrillation and transient ischemic attack.
Due to this, she was refrained from driving the uber until her next visit to the neurologist for the
next two weeks. This saddens her and makes her regret ever going to the emergency room. This
essay focuses on answering the following questions; firstly, the chronic illness that Liz is at risk
of developing. Secondly, an identification of the health services that are available in Australia
that would aid Liz in managing the risk of developing the chronic illness identified above.
Thirdly, this is a reflection on the services that Liz received. Lastly, a conclusion summarizing
the essay.
Question one: Right ventricular failure translating to heart failure.
Patient Liz is disposed to Right Ventricular Dysfunction/heart failure. The relationship
between the right ventricular failure and the chronic pulmonary diseases was described by
Laennec 200 years ago as “all the diseases that cause severe and a long continuous period of
dyspnea, they cause hypertrophia or the heart dilation due to the constant efforts of the heart to

CHRONIC ILLNESS 3
perform, so as to take blood into the lungs against the opposing resistance which results from the
dyspnea. This is common in chronic lung diseases as there are structural changes of the lung
parenchyma and an abnormality in the functioning of the gas exchange that causes pulmonary
hypertension with the hypertrophy and remodeling of the right ventricle (Kolb & Hassoun 2012).
In addition to this, the chronic hypoxemic and the disruption of the pulmonary vascular beds
causes an increase in the ventricular afterload. This is generally defined by the marked
hypertrophy with a preserved cardiac output and myocardial contractility. The right ventricular
failure is a rare disease except during chronic lung disease. Research finding on patients with
chronic lung diseases indicates that 26% of the American deaths are as a result of pulmonary
hypertension. It was also reported that 30-70% of the chronic obstructive pulmonary diseases get
pulmonary hypertension which further causes the right ventricular failure (Kolb & Hassoun
2012; Brown et al., 2016).
Similarly, the mortality (more than 50%) cases of chronic obstructive pulmonary disease
(COPD) the most common cause is a cardiac failure and not a respiratory failure. COPD is the
most common cause of mortality and morbidity of the adults that are heavy and medium
smokers. As mentioned above COPD, impacts the functioning of the right ventricle. In COPD
the decreased/limitation of the airflow causes an increase in the pulmonary resistance which
causes an increased afterload on the right ventricle. The increased resistance causes hypoxic
vasoconstriction, pulmonary vascular remodeling. This structural changes in the pulmonary
vascular results from the inflammation induced by tobacco smoke and this are amplified by the
chronic hypoxemia. This later causes pulmonary hypertension which complicates COPD
(Chhabra & Gupta 2010). The right ventricle responds to this by undergoing dilatation and
hypertrophy. This structural adaptation causes an increased end diastole pressure, a reduced right