- Dong Mr Jones A 50 Year Old Sales Executive Has Arrived In Washington Dc For A Convention He Decides To Go Out With H 1 (32.39 KiB) Viewed 11 times
- Dong Mr Jones A 50 Year Old Sales Executive Has Arrived In Washington Dc For A Convention He Decides To Go Out With H 2 (43.82 KiB) Viewed 11 times
dong Mr. Jones, a 50 year old sales executive has arrived in Washington DC for a convention. He decides to go out with his colleagues and has a heavy ginner. He wakes up in the middle of the night with a dull ache in the center of his chest. He initialy thinks, it is indigestion from the heavy meal that he had, but the chest pain gets worse and now starts radiating to the left shoulder, left jaw, and left arm He remembers sering on TV, that what he is experiencing could be symptoms of Myocardial infarction theart attack). He immediately call 911. Once the ambulance amies, the EMT notices that Mr. Jones is sweating profusely and he is pale. The EMT immediately gives Mr. Jones, Aspirin, puts on an oxygen mask, and starts IV normal saline. I needest, other drugs can be given via IV access As soon as Mr. Jones is brought to the hospital, the TR nurse takes the vital signs and a brief history. An EKG is done and shows abnormalities, supting a M. Blood is drawn to look for carduc enzymes Blood results are back and show elevated Troponin and Creatine Kinase, confirming that Mr. Jones is having a Mt His past medical history is significant for poorly controled long-standing essential hypertension, poorly contrated Diabetes melits, and poorty controlled Hypercholesterolemia. His family history is unremarkable. He is a current snuker, has smoked 2 packs of cigarettes for the last 25 years, and drinks beer on the weekends. Vital signs Complete blood count Cardiac enzymes BP 100/110mmig Hemoglobin 19 m HR:97 tom Hemat: 0% Temperature 98 Leucocytes 5000 cells/ Platelets 200,000 Troponin 0.030 0012) Creatine kinase 120 / normal 25-90 U/X) Jones immediately taken to the operating room to do an Angiogram la procedure to visuale his coronary blood vessels) The doctors flod a thrombus in the left sesterior descending artery (LAD) that is decreasing the blood flow In a factor of 16 A decision is made to do an angioplasty Inior surgery is done to open blocked arteries Due to an error in the procedure, there are bleeding complications and Mens now requires a tad trendusion Hess All Negative. His conden stabies after the transfusion Tive days post angioplasty, the UKG comes back to normal and his cantuc onrymes are trending down. The physician decides to observe him in the hospital for 2 days. He is discharged on the 7th day, with advice to make ifestyle changes and start medications Aspinn, Metoprolol eta blockers Atorvastatin for his high cholestéroll and folow up with his physician in his town Mr. Jones was not compliant with his medications, made no changes to his festyle 3 months later, be visits his physician and complaies of easy fatigabilty, headaches, shortness of breath, unable to lie at on the bed at night. He says that he has to sit up propped up against 4 pilows in order to sleep. On Auscultation of the chest, there are bilateral crackles heard. The physician concludes that Mr. Jones is in heart failure. He now in M
The angiogram showed a thrombus in the left anterior interventricular artery, which part 6b of the heart would be damaged due to this occlusion? (1 point). 6c If the ventricle of the heart is damaged, which wave/ waves of the EKG will change?.( 1 point) 7 As a result of the Myocardial infarction and death of the effected cardiac muscle, (answer the following 3
questions) 7a What happens to the stroke volume of the ventricle and why? (1 point) 7b As a result of the change in stroke volume from 7a, what happens to the cardiac output and total peripheral resistance (R) (1 point) 7c Why is giving a Beta-blocker advantageous in Myocardial infarction (1 point)