Case Study - Severe Pain at the Chest

Running head: CASE STUDY0
CASE STUDY
Name of the Student:
Name of the University:
Author Note:

Running head: CASE STUDY1
Introduction:
The paper aims to discuss a case study on a 68 years old patient, named Gordon
Deltori using the clinical reasoning cycle. The case describes the patient as a taxi driver who
was presented in the ED. The patient was experiencing a dull and achy pain in the chest that
was radiating to his neck from the last night. According to the patient, the pain is more severe
at present compared to the last night. Mr. Deltori had a few past medical conditions, such as
hypertension, osteoarthritis, type-II diabetes, and atrial fibrillation condition, along with a
habit of smoking. The patient also had a high BMI that indicated him to be obese. His vital
observation results suggested that he has high blood pressure. Firstly, the paper will discuss
the case study using the six steps of the clinical reasoning cycle, and after that, the
pharmacokinetics of two of the prescribed medications for Mr. Deltori will also be discussed.
Discussion:
Description of the Problems:
The case study describes the main symptom experienced by the patient was a severe
pain at the chest. The last night before he was presented to the ED of the hospital, he felt a
tightness in his chest before he went to sleep. He woke up with severe pain at his chest. He
took his anginine medication, but he did not feel relief even after that. After his presentation
at the hospital, he described his pain to have become more severe than last night. Mr. Deltori
appeared to be older than his actual age, and he was sweating continuously. His blood
pressure was also high. However, he did not experience the symptoms like shortness of
breath, and his respiratory rate and his heart rate also appeared to be normal upon
examination.

Running head: CASE STUDY2
Collection of the Information:
The angina pain Mr. Deltori was experiencing, he described it to be a dull and achy
pain, which was radiating to his neck. The examination of the palpation of his peripheral
pulses found that all his pulses to be palpable. There was also a visible pulsation of the
precordium and in the supine position of the neck. The patient had a history of type 2
diabetes, hypertension condition, atrial fibrillation, and osteoarthritis conditions. He was
prescribed with perindopril medication for his hypertension condition, apixaban for his atrial
fibrillation condition, metformin for his diabetic condition, vitamin D for his osteoarthritis
condition, and anginine for his possible angina condition (Boden et al., 2015). Mr. Deltori
had to take the anginine medication only three times within the last five months, and last
night was the first time he felt that the medication was not working. His wife, however,
reports that he does not take his medications regularly and does not go through a regular
check-up. He also has a habit of smoking from fourteen years of age, which has not been able
to quit.
Processing of the Information:
The analysis of the symptoms suggested that Mr. Deltori was experiencing an angina
attack, which is a disease condition that results when the heart muscles do not get the
required oxygen (Goyal & Zeltser, 2019). The condition is a common co-morbid condition
for the atrial fibrillation condition in a patient (Kea, Manning, Alligood & Raitt, 2016). His
other past medical histories, such as the hypertension condition and the diabetic condition,
might also have a contributing effect on increasing the severity of his symptoms (Manolis,
Kallistratos & Poulimenos, 2019). The pathophysiology of the disease condition can be
explained as follows.
The atrial fibrillation condition can be described as a disease condition when the atria
of the heart fail to beat with proper co-ordination with the ventricles. This event results in a