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Presenting Complaint and Signs & Symptoms | Coronary Artery Disease

   

Added on  2020-05-11

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1Running head: NURSINGNursing Name of student:Name of university:Author note:

2NURSING Patient History Mr Jones was a 46-year-old male patient admitted to the Coronary Care Unit of thehealthcare setting at 7:30 pm. He came into the Emergency Room at around 4 pm. Thepatient had the chief complaint of left-sided chest pain that persisted for two hours beforepresenting to the hospital. Mr Jones was slim built and tall and weighed 76 kg with a heightof 181 cm. He had been admitted to the hospital for a stroke two and a half years ago. He hada history of hypertension and had been attending the medical clinic for the same. His familyhistory included hypertensive parents. Mr Jones was a professor by profession and deniedalcohol intake. He, however, had a history of smoking and smoked five cigarettes a day. Hestayed with his wife and two children and led a sedentary lifestyle. Presenting Complaint and Signs & Symptoms The crushing pain in the left side of the chest was the main patient concern. Thepatient reported that he was having a crushing pain along with shortness of breath, sweatingand sense of impending doom. His vital signs were BP 140/95 mmHg; temperature 36degrees Celsius; pulse rate 63 bpm; RR 22 bpm. Pathophysiology Coronary artery disease in patients is the result of atherosclerosis which is theprogression of building up of fatty tissues in the arterial walls, commonly known as plaque(Bellchambers et al., 2017). The formation of plaque in one or more than one places causesnarrowing of the arteries that in turn slows the flow of blood into the heart. Since the bloodflow is restricted or stopped, the patient experiences chest pain and shortness of breath, acondition medically known as Myocardial Infarction (MI). Myocardial Infarction results fromthe thrombotic occlusion of the coronary artery. Necrosis and irreversible cell injury are the

3NURSING ultimate outcomes (O'Gara et al., 2013). Another significant cause of reduced blood supply isartery spams. At times, an artery of the coronary system might momentarily undergocontraction, leading to spasm. This occurs when the artery is narrowed, and blood flow isrestricted. A spasm is likely to happen in normal-appearing blood vessels as well as those thatare blocked by atherosclerosis. Myocardial Infarction is caused due to a severe spasm(Montalescot et al., 2014). The major risk factors for MI are hypercholesterolemia,hypertension, smoking and diabetes. The three criteria for the diagnosis of MI as outlined bythe World Health Organization are patient symptoms of prolonged and severe chest pain,serial enzymes and electrocardiography changes. During the initial phase of MI, the patient had suffered chest pain, profuse sweatingand shortness of breath. The sense of impending doom was also an effect of such condition.The chest pain can be considered as the hallmark of acute MI (Nkhomaet al., 2016). The painthat Mr Jones had experienthe patient suffered from initially was owing to blockage of acoronary artery. The injury caused to the heart muscle deprives it from an adequate supply ofoxygen and blood, leading to sensations of chest pressure and chest pain (Levine et al., 2015).Shortness of breath is due to the left ventricle being affected by the infarction and reductionof cardiac output. The sense of impending doom is a result of the release of adrenaline andother catecholemines which acts as a component of the compensation mechanism.Sympathetic activation leads to profuse sweating (Johnson & Craft, 2017). Examination Outcomes An Electrocardiograph (ECG) revealed that changes were distinctive ST elevations inleads I, aVL, V2, V3, V4, V5 and V6. Laboratory investigations have indicated a bloodcount, normal levels of creatinine, urea, chloride, sodium, potassium, liver enzymes. Thetriglyceride and cholesterol levels were elevated significantly. He was alert and had a suitable

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