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Question

Ms. X., aged 55 years, has been complaining of severe fatigue and “indigestion.” Her son is quite concerned and decides to take her to the emergency department. On arrival she appears very anxious, and her facial skin is cool and clammy; her blood pressure is 90/60, and the pulse is around 90, weak, and irregular. She is given oxygen, an intravenous line is opened, and leads for ECG are attached. Blood is taken for determination of serum enzymes and electrolytes. Tentative diagnosis is myocardial infarction involving the left ventricle. Her son provides information that indicates Ms. X is a long-time smoker, has a stressful job as a high school teacher, is recently separated after 20 years of marriage, and is fearful of losing the family home. She has also seemed to be more fatigued and stopped going to the gym about 18 months ago. She has begun to rely on “fast foods” like pizza and fried chicken and cooks infrequently. Her father had died of a heart attack at age 50. She had also noticed more fatigue and intermittent leg pain when walking or climbing stairs at work. Generalized atherosclerosis is suspected.

List the high-risk factors for atherosclerosis in this patient’s history.

Describe how atherosclerosis causes myocardial infarction.

It is suspected that the indigestion reported in the history was really angina. Explain how this pain may have occurred.

Explain each of the admitting signs.

What is “atypical” in Ms. X’s symptoms? How does this affect treatment and prognosis?

What information do serum enzyme and electrolyte levels provide?

What purpose does the ECG serve? It is determined that Ms. X. has a large infarct in the anterior left ventricle.
Step 1/2

Atherosclerosis is a condition where the arteries become narrow and rigid due to the accumulation of plaque on the arterial walls. The plaque is composed of fatty deposits, cholesterol, and other substances. Over time, the plaque can restrict blood flow and increase the risk of developing serious health problems such as heart disease, stroke, and peripheral artery disease. Risk factors for atherosclerosis include high cholesterol, high blood pressure, smoking, a diet high in saturated and trans fats, obesity, and a sedentary lifestyle. The goal of treatment is to reduce the risk of plaque formation and progression, through lifestyle changes and medical interventions, such as medication, surgery, and angioplasty. Symptoms of Severe Fatigue and Indigestion Essay Sample
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Step 2/2

High-risk factors for atherosclerosis in this patient's history include: smoking, stress, poor diet with high intake of fast foods, lack of physical activity, family history of heart disease, and advancing age.
Atherosclerosis is a condition where the arteries become narrow and rigid due to the accumulation of plaque on the arterial walls. This plaque can rupture, leading to a blood clot that blocks the flow of blood to the heart muscle, causing a myocardial infarction (heart attack).
Angina pain occurs due to insufficient blood flow to the heart muscle, which can be caused by atherosclerosis-narrowed coronary arteries. The pain is usually described as a tight, heavy or pressure-like sensation in the chest that can also spread to the arm, neck, jaw, or back.
The admitting signs in this patient include: anxiety, cool and clammy facial skin, low blood pressure (90/60), rapid and irregular pulse (90), and severe fatigue. These signs may indicate decreased perfusion of blood and oxygen to the body and possible heart damage.
Atypical symptoms in this patient include the intermittent leg pain when walking or climbing stairs, which may indicate claudication due to peripheral artery disease caused by generalized atherosclerosis. This atypical presentation may affect treatment and prognosis as it may be overlooked and not properly diagnosed.
Serum enzyme and electrolyte levels provide important information about the functioning of organs, including the heart. In this case, elevated levels of cardiac enzymes (such as troponins) may indicate myocardial injury and support the diagnosis of a heart attack.
The ECG serves to provide information about the electrical activity of the heart, including the heart rate and rhythm, and can help diagnose a heart attack. The finding of a large infarct in the anterior left ventricle supports the diagnosis of a heart attack and highlights the need for prompt and appropriate treatment.

Final answer

In conclusion, Ms. X is a 55-year-old patient who presents with symptoms of severe fatigue,

Expert Answer

Question

Ms. X., aged 55 years, has been complaining of severe fatigue and “indigestion.” Her son is quite concerned and decides to take her to the emergency department. On arrival she appears very anxious, and her facial skin is cool and clammy; her blood pressure is 90/60, and the pulse is around 90, weak, and irregular. She is given oxygen, an intravenous line is opened, and leads for ECG are attached. Blood is taken for determination of serum enzymes and electrolytes. Tentative diagnosis is myocardial infarction involving the left ventricle. Her son provides information that indicates Ms. X is a long-time smoker, has a stressful job as a high school teacher, is recently separated after 20 years of marriage, and is fearful of losing the family home. She has also seemed to be more fatigued and stopped going to the gym about 18 months ago. She has begun to rely on “fast foods” like pizza and fried chicken and cooks infrequently. Her father had died of a heart attack at age 50. She had also noticed more fatigue and intermittent leg pain when walking or climbing stairs at work. Generalized atherosclerosis is suspected. List the high-risk factors for atherosclerosis in this patient’s history. Describe how atherosclerosis causes myocardial infarction. It is suspected that the indigestion reported in the history was really angina. Explain how this pain may have occurred. Explain each of the admitting signs. What is “atypical” in Ms. X’s symptoms? How does this affect treatment and prognosis? What information do serum enzyme and electrolyte levels provide? What purpose does the ECG serve? It is determined that Ms. X. has a large infarct in the anterior left ventricle.

Step 1/2

Atherosclerosis is a condition where the arteries become narrow and rigid due to the accumulation of plaque on the arterial walls. The plaque is composed of fatty deposits, cholesterol, and other substances. Over time, the plaque can restrict blood flow and increase the risk of developing serious health problems such as heart disease, stroke, and peripheral artery disease. Risk factors for atherosclerosis include high cholesterol, high blood pressure, smoking, a diet high in saturated and trans fats, obesity, and a sedentary lifestyle. The goal of treatment is to reduce the risk of plaque formation and progression, through lifestyle changes and medical interventions, such as medication, surgery, and angioplasty. Symptoms of Severe Fatigue and Indigestion Essay Sample

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Step 2/2

High-risk factors for atherosclerosis in this patient's history include: smoking, stress, poor diet with high intake of fast foods, lack of physical activity, family history of heart disease, and advancing age.
Atherosclerosis is a condition where the arteries become narrow and rigid due to the accumulation of plaque on the arterial walls. This plaque can rupture, leading to a blood clot that blocks the flow of blood to the heart muscle, causing a myocardial infarction (heart attack).
Angina pain occurs due to insufficient blood flow to the heart muscle, which can be caused by atherosclerosis-narrowed coronary arteries. The pain is usually described as a tight, heavy or pressure-like sensation in the chest that can also spread to the arm, neck, jaw, or back.
The admitting signs in this patient include: anxiety, cool and clammy facial skin, low blood pressure (90/60), rapid and irregular pulse (90), and severe fatigue. These signs may indicate decreased perfusion of blood and oxygen to the body and possible heart damage.
Atypical symptoms in this patient include the intermittent leg pain when walking or climbing stairs, which may indicate claudication due to peripheral artery disease caused by generalized atherosclerosis. This atypical presentation may affect treatment and prognosis as it may be overlooked and not properly diagnosed.
Serum enzyme and electrolyte levels provide important information about the functioning of organs, including the heart. In this case, elevated levels of cardiac enzymes (such as troponins) may indicate myocardial injury and support the diagnosis of a heart attack.
The ECG serves to provide information about the electrical activity of the heart, including the heart rate and rhythm, and can help diagnose a heart attack. The finding of a large infarct in the anterior left ventricle supports the diagnosis of a heart attack and highlights the need for prompt and appropriate treatment.

Final answer

In conclusion, Ms. X is a 55-year-old patient who presents with symptoms of severe fatigue, "indigestion," and irregular pulse. Upon admission, her history and physical examination suggest the presence of high-risk factors for atherosclerosis, including smoking, stress, poor diet, lack of physical activity, family history of heart disease, and aging. It is suspected that the indigestion is really angina pain caused by narrowed coronary arteries due to atherosclerosis. The admission signs and the ECG results support the diagnosis of a myocardial infarction in the anterior left ventricle. The serum enzyme and electrolyte levels provide important information about the functioning of the organs and support the diagnosis of a heart attack. The atypical presentation of her symptoms, including the leg pain, highlights the importance of a comprehensive evaluation and proper diagnosis. Symptoms of Severe Fatigue and Indigestion Essay Sample

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