Electrocardiogram Question Answer 2022

QUESTION 1
The electrocardiogram – ECG is a critical test undertaken in the medical assessment
protocols. The ECG has ST elevation which depicts serious heart distress signal and this
necessitates heart treatment immediately. ECG is recommended when the patient has a
depiction of chest pain and signs of shortness of breathing as depicted by the patient in the
case study (Karimian, Guo, Tehranipoor & Forte, 2016).
ECG offers an electronic reading assessment and reflects impulses which activate the
heart muscles and the overall blood pumping ability. The electrodes fixed at various sites of
the body sends signals to be assessed. The ECG offers an avenue of pattern recognition
which is essential in diagnosing the state of the patient (Breen, Kelly & Kernohan, 2019).
During a normal heartbeat, the activity often depicts small pacemaker patch cells
indicating electrical activity. The various electrodes affixed to the body on the chests and
arms produces the electrical impulses which are crucial for assessing the pumping mechanism
of the heart. During the normal heartbeat, the electrical activity indicates small patches
referred to as the sinus node. Activation of the atria by the impulse produces small blip
referred to as the P wave. Thereafter the pumping chamber, ventricles produces up and down
in the middle referred to as the QRS complex. The T wave at the end refers to the recovery
period during the reverse impulse movement (Sullivian et al., 2018).
As the patient symptoms signify intense chest pains, referred to as angina, the heart
muscles work in a strenuous state getting inadequate blood and oxygen, the ST portion dips
downwards instead of showing flat level. This is indicated in Lead I, II and III, as observed in
the arrow indicated in the diagrammatic representation below.
Further, from the ECG assessment of serious heart attack can be diagnosed. The ST
segments of the ECG in normal patient assessment often are flat. The occurrence of humped
and raised appearances indicates a serious heart attack (Doubell, 2017). This is depicted in
the diagram below obtained from the image of the patient.

Further, signs of atrial fibrillation on the upper chambers of the heart are indicative on
the ECG. There is an occurrence of chaotic observation and irregular pumping occurring
(Magnusson, et al., 2019). The P wave does not reflect and occurrence of the jumpy baseline
is observed. the occurrence of the QRS complex is observed on lead II lower line on the ECG
diagram as observed on the image below;
Coronary atherosclerosis
Etiology
Coronary atherosclerosis is a pathological process which hampers the large and
medium arteries leading to coronary artery disease. Atherosclerosis reflects chronic
cumulative plaque formed on the vessels walls leading to necrotic cores, modified lipids and
inflamed smooth muscles. Coronary heart disease relates to the reduction of blood movement
to the muscles as a result of build-up plaque on the heart arteries. It is often the most common
form of cardiovascular diseases. Various types of this state entail stable angina, unstable
angina, myocardial infarction, and even cardiac arrest (Ambrose & Singh, 2015).
The development of coronary heart diseases often occurs after a longer period, which
progresses on to the development of chest pain. Diagnosis is often made from ECG
assessment.
Pathogenesis
Atherosclerosis occurrence begins with medium and large arteries which are affected
by patchy thickening of the sub- intima arterial wall encroachment. Lesion appearance is
observed by fatty streak due to lipid accumulation from cells in the artery intimal layer. Over
time the fatty streak develops into plaque leading to atherosclerosis. This leads to blockage of
blood flow. Typically the occurrence emanates from the development of atherosclerosis

affecting the lining of the heart muscles accumulating deposits of calcium, fatty lipids and
inflammatory cells forming a plaque which in turn blocks the blood flow to the heart (Di
Pietro, Formoso & Pandolfi, 2016).
Myocardial ischemia
Etiology
Myocardial ischemia occurs as a result of reduced blood flow to the heart due to partial
blockage of the heart arteries. The encountered regional infarcts result from lack of blood
flow on the epicedial artery blocking by the thrombus occurring due to lack of oxygenation. It
is also referred to as cardiac ischemia and reduces the ability of the heart muscles to pump
blood. Severe blockage can lead to a heart attack and is often indicative of abnormal heart
rhythms (Yahagi et al., 2016).
Pathogenesis
The occurrence of myocardial ischemia often occurs due to decreased blood flow. It
often develops over time as the arteries are blocked. States which might lead to this include,
atherosclerosis due to building plagues from cholesterol matter, blood clot due to rupture
blocking the artery and coronary spasms. Spasms occur due to a temporal tightening of the
muscles on the arterial wall thus preventing the flow of blood on the heart muscle. Various
conditions such as coronary heart disease, blood clot and coronary artery spasm can lead to
blockage of the leading to myocardial ischemia (Ibanez, Heusch, Ovize & Van de Werf,
2015).
QUESTION 2
Physiologic effects of the medications administered
The patient has been administered three drugs namely Aspirin, Glycerine Trinitrate
(GTN) and morphine to offer a combined therapeutic effect. aspirin belongs to the
acetylsalicylic acid call and is often used for the relief of pain. Often it is administered after
the occurrence of a heart attack which decreases the risks of death hence the administration at
the emergency department. On long term use, it is used to prevent the occurrence of heart
attack, ischemic strokes and blood clots especially from high risks category of people
(National Clinical Guideline Centre-UK, 2015).