Case Study Analysis: Healthcare Risk Factors and Patient Outcomes

This case study analyzes Mrs. Paula Johnson, a 65-year-old woman with multiple comorbidities, including hypertension, hypercholesterolemia, and type II diabetes, and a sedentary lifestyle. The analysis explores her increased risk of heart attack due to these conditions and her history of smoking. The study defines heart attack, discusses the patient's specific risk factors, and explains the concept of tissue perfusion and how her conditions affect it. It also describes hypertension and pneumonia, highlighting the patient's risk factors for these conditions. The analysis concludes with a reflection on the insights gained from the case, emphasizing the importance of healthy lifestyle choices and self-management strategies to prevent further complications and improve patient outcomes. References from various medical journals support the analysis.

Running head: CASE STUDY ANALYSIS
CASE STUDY ANALYSIS
Name of the student
Name of the university
Author’s name

CASE STUDY ANALYSIS
What are your initial reactions related to the case?
As it can be seen in the case study, Mrs. Paula Johnson, a 65 year old woman has
multiple comorbid conditions like hypertension, hypercholesterolemia, and diabetes mellitus
type II and practices sedentary lifestyle. Evidence suggest that all these above conditions
increase the risk of developing cardiac condition ultimately leading to heart attack. In addition to
the above conditions, the patient was also a heavy smoker since she was 20. Smoking is a major
risk factor for heart attack, thus, the patient is at a higher risk of having cardiovascular diseases
and other related conditions ultimately leading to heart attack. For individuals suffering from
these chronic conditions, it is important to make healthy lifestyle choices, which the patient
failed to adhere.
What is a heart attack?
Heart attack, also called myocardial infarction occurs as a result of decrease in blood
flow that cause immense damage to the heart. Most of the heart attacks occur as a result of
coronary heart disease or rupture of an atherosclerotic plaque on an artery that supplies the heart
muscle. The common clinical manifestations of heart attack include discomfort and chest pain
that may travel to arm, shoulder, neck, back or jaw creating severe discomfort, shortness of
breath, nausea, fatigue and fainting. It usually occurs at the center or in the left part of the chest
lasting for more than a minute. Heart attack is a serious concern as it can even lead to mortality
if not treated on priority basis. The prevalence of heart attack increases with increasing age and
are more common in individuals with chronic conditions such as hypertension, diabetes,

CASE STUDY ANALYSIS
hypercholesterolemia, and diabetes mellitus type II, smoking and sedentary lifestyle that are
evident in the patient in the case study (Hajar 2017).
Considering Mrs Johnson’s case, why does she have an increased risk of
having a heart attack?
Mrs. Johnson has several chronic conditions like diabetes, hypertension,
hypercholesterolemia which are major risk factors for heart attack. Other risk factors include lack
of physical activity and smoking which are evident in Mrs. Johnson. Studies show that
individuals with sedentary lifestyle are more susceptible to chronic diseases like diabetes,
hypertension and other comorbidities that increases the risk of heart attack. Thus, for people
suffering from these chronic conditions, it is important to develop and implement self-
management strategies that will prevent these conditions and increase the health outcome.
However, Mrs. Johnson have chosen to lead a sedentary lifestyle that affected her health and
increased her risk of developing further complications such as heart attack.
What is tissue perfusion? Which of the patient’s conditions can alter tissue
perfusion? How?
The process of passing of fluid through the lymphatic or circulatory system to an organ or
tissue is known as perfusion. Tissue perfusion is considered as a critical parameter for the
survival and function of the tissue and both relative as well as absolute perfusion assessments are
conducted to diagnose and evaluate the response of the therapy. It is dependent on blood flow
and governed by the stroke volume which is affected by the blood flowing to the heart, cardiac
contractility, and arterial blood pressure that the heart overcomes for pushing blood through

CASE STUDY ANALYSIS
pulmonic and aortic valves, called afterload. Afterload causes hypertension is highly affected by
peripheral vascular resistance or vasomotor tone, which when increased results in fall in
perfusion and cardiac outcome (He et al. 2015).
What is hypertension? How does hypertension alter tissue perfusion?
The normal blood pressure ranges between 120/80 mmHg. Readings over 140/90 mmHg
indicates a higher blood pressure which requires urgent medical attention. It is a long term
condition and is a major risk factor for cardiac diseases having lifelong implications.
Hypertensive patients have an elevated blood pressure in the arteries with no significant clinical
manifestations. In hypertension, capillary rarefaction persuades an increase in the blood pressure
leading to a relative decrease in tissue perfusion that poses an increased cardiovascular risk
(Koeners et al. 2016).
Describe pneumonia. What risk factors does the patient have for pneumonia?
Pneumonia is a severe infection caused by bacteria, fungi and viruses and usually affect
lungs. It causes an inflammation in the air sacs of the lungs called alveoli affecting the
surrounding tissue. Symptoms of pneumonia include high fever, cough and shortness of breath
(Mackenzie, 2016). The patient is a heavy smoker which is a leading risk factor for pneumonia.

CASE STUDY ANALYSIS
What have you learned from their perspectives on the case? Has it changed
the way in which you view the case? In what way?
I have learnt that Mrs. Johnson has several chronic conditions like diabetes, hypertension,
hypercholesterolemia which are major risk factors for heart attack. In addition to that, she is
aged, practice sedentary lifestyle and smokes heavily that are major risk factors for heart attack.
In order to prevent and increase the quality of life, she must make healthy lifestyle choices and
adhere to self-management strategies.

CASE STUDY ANALYSIS
References
Hajar, R., 2017. Risk factors for coronary artery disease: historical perspectives. Heart views:
the official journal of the Gulf Heart Association, 18(3), p.109.
He, H., Long, Y., Liu, D., Wang, X. and Zhou, X., 2015. Clinical classification of tissue
perfusion based on the central venous oxygen saturation and the peripheral perfusion
index. Critical Care, 19(1), p.330.
Koeners, M.P., Lewis, K.E., Ford, A.P. and Paton, J.F., 2016. Hypertension: a problem of organ
blood flow supply–demand mismatch. Future cardiology, 12(3), pp.339-349.
Mackenzie, G., 2016. The definition and classification of pneumonia. Pneumonia, 8(1), p.14.
Stewart, J., Manmathan, G. and Wilkinson, P., Primary prevention of cardiovascular disease: A
review of contemporary guidance and literature. JRSM Cardiovasc Dis. 2017; 6:
2048004016687211.