(pdf) Paramedical sciences and services
Added on 2021-05-30
12 Pages3441 Words31 Views
Test PrepDisease and DisordersNutrition and WellnessHealthcare and Research
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Running head: PARAMEDICINEParamedicineName of the StudentName of the UniversityAuthor note
2PARAMEDICINEIntroduction The essay discusses the hospital management of the patient named Amit Singh, 58 yearold presented with the chest pain and vomiting. In response to the case study the essay discussesthe pathophysiology of the presenting condition of the patient along with brief highlight on theepidemiology and the risk factors. The essay further presents the hospital management of thepatient’s condition. The essay discusses in details about the general management of the conditionas well as the national and international guidelines used in this process. The evidence issupported with literature and the factors such as hospital, geographical, or regional factors thatmay affect the patient management are also discussed. Patient presenting condition In the given case study the patient was NBN installer and was travelling for work. Whileworking in the remote area the person had onset of nausea and vomiting with pain in his chest,left arm and jaw thirty minutes ago. It was described by the bystander that the Mr Singh quicklybecoming pale and sweaty before vomiting. The past medical history of the patient reveals of theHypertension,hypercholesterolaemiaand type two diabetes mellitus. There is the family historyof heart attack (in case of father) and stents (in case of brother). The patient’s social historyreveals him to have a sedentary lifestyle with poor diet pattern. The patient consumes fat richfood and high sugar containing diet. It is because the patient is traveler and mostly eats outsidehome. On examination it was fund that the patient had central chest pain that is described by thepatient as heavy like sitting on chest and rated severity is 7/10. The patient feels tighteningnumbness in left arm and jaw. The pain is persistent and non changing with the associatedsymtoms like Nausea, vomiting, pallor and diaphoresis. On observation the patient showed up
3PARAMEDICINEwith respiratory rate 18, SpO2: 97% on air, regular heart rate- 104bpm, and Blood pressure:142/87. Based on physical examination, presenting symptoms, and ECG the patient can beinterpreted to have ischemia that is coronary ischemic heart disease (1). Pathophysiology Heavy chest pain is related to heart attack. According to (2) coronary ischemia is thecondition caused by the insufficient blood through the coronary arteries. It is linked with heartattack and heart diseases. The typical symptoms of the coronary ischemic heart disease are thechest pain that is heavy as someone sitting in chest. This pain does not persist after rest butoccurs during strenuous activity such as exercise. It is accompanied with other symptoms such assweaty palms or diaphoresis, nausea or vomiting (3). The other typical symptoms of thecoronary heart disease are the radiating chest pain towards left arm (4) which are all presented bythe patient. The underlying cause of the diseases is the blockage of the walls of the coronaryarteries by fatty substances. It is known as atheromaof thecoronary arteries causing occlusion.It leads to narrowing of the arteries and the constricted blood flow. This process is also called asthe Arthrosclerosis which is the common cause of coronary ischemia. It is characterized by thenarrowing of the arteries due to building up of plaque made of cholesterol. It decreases the bloodflow to the heart increasing the risk of the myocardial infarction that is the damage to the heartmuscle. The patient feels nausea due to vagus nerve arising in the brain, through esophagus givesthe nerve fibers to the heart. It then continues to the abdomen giving nerves to stomach. It is dueto this stomach-heart-brain connection that the patient feels nausea and vomiting (4). Epidemiology and risk factors
4PARAMEDICINEThe pathophysiology is justified considering the symptoms of the cardiac ischemia inpatients along with the risk factors. It includes high blood pressure, diabetes, high bloodcholesterol level and lack of physical activity, pain for more ten minutes (4,5, 6). High bloodpressure accelerates the arthrosclerosis, resulting in damage of the coronary heart disease. Highcholesterol or bad cholesterol mainly causes the deposition and narrowing of arteries (lowdensity lipoprotein in blood). It is attributed to hereditary and dietary conditions (diet high insaturated fats and cholesterol). Further, physical activity like exercise lowers the risk of highblood pressure (4,5). Age and sex are the other risk factors of the ischemic heart disease. Mendie from this disease at the rate twice as that of women and the sex bias is consistent over time.In case of woman the proportion of death due to this disease increases with age. Death rateincreases among women above 85 years of age. This proportion is much higher at younger agefor man. More than 1 in 10 deaths is noted in males above 45 years and above (5). As per (5) cardiac ischemia and acute myocardial infarction as a subsequent outcome, ispresent in approximately 6% of all hospital admissionsfor heavy chest pain. Cardiac ischemia isthe common cause of death in western affluent countries. In Australia, the ischemic heart diseaseis the leading cause of the death, with 12.4% of the 159,052 deaths (7). People with diabeteshave 10-20% risk of silent ischemia when compared to rate of 1% to 4% in nondiabetics. Indeveloped countries the coronary ischemia heart disease is the major cause of the death anddisability in people above 35 years. However, past four decades of records show decline in thedeaths due to the Coronary heart disease. The growth of the population and the increase in agedpeople led to higher global burden of the ischemic heart disease since 2010 (8). ECG interpretation
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