The patient is a 72-year-old man who had an extensive left ventricular myocardial infarction (MI) at 36 years of age. At
Posted: Wed Mar 09, 2022 9:45 am
The patient is a 72-year-old man who had an extensive left
ventricular myocardial
infarction (MI) at 36 years of age. At the time of his MI, he
was overweight by 50
pounds and smoked two packs of unfiltered cigarettes per day. He
had smoked
for 20 years. Alcohol consumption was part of his ethnic
background; it was customary for him to drink one or two beers per
day and several mixed drinks per
week. His father had also suffered an MI at the age of 48, and
was a chain smoker.
The patient slowly recovered from his MI, gave up smoking, and
lost weight. His
weight stabilized within 15 pounds of the upper limit of his
ideal weight. His wife
became an active participant in his recovery by changing her
style of cooking
and virtually eliminating saturated fats from their diets. He no
longer drank beer,
but he continued to consume an average of two mixed drinks per
day. He began
a moderate exercise program that included walking several miles
at least three
times a week. He has had stable angina for many years and has
annual physical
checkups and ECGs at the cardiologist’s office. He took up the
hobby of downhill
skiing at the age of 66, with his cardiologist’s approval. He is
a retired accountant
with a type A personality. Over the past 6 months, he has
experienced infrequent
periods of lightheadedness. He has “blacked out” on at least one
occasion and
was unable to remember any details of what happened. A second
episode of loss
of consciousness occurred on a clear, cold winter day while he
was skiing. He
revived spontaneously. The next day, he scheduled an appointment
with his physician. The cardiologist performs an ECG and orders
bloodwork drawn for serum lipids, troponins, AST, CK and CK-MB, LDH
and isoenzymes, serum potassium, and C-reactive protein. The
patient is scheduled for an inpatient cardiac catheterization. The
physician tells him that, based on the findings at the time of the
catheterization, he may go ahead and perform an angioplasty.
(2) list two assessments and
the Rationale for each assessment.
ventricular myocardial
infarction (MI) at 36 years of age. At the time of his MI, he
was overweight by 50
pounds and smoked two packs of unfiltered cigarettes per day. He
had smoked
for 20 years. Alcohol consumption was part of his ethnic
background; it was customary for him to drink one or two beers per
day and several mixed drinks per
week. His father had also suffered an MI at the age of 48, and
was a chain smoker.
The patient slowly recovered from his MI, gave up smoking, and
lost weight. His
weight stabilized within 15 pounds of the upper limit of his
ideal weight. His wife
became an active participant in his recovery by changing her
style of cooking
and virtually eliminating saturated fats from their diets. He no
longer drank beer,
but he continued to consume an average of two mixed drinks per
day. He began
a moderate exercise program that included walking several miles
at least three
times a week. He has had stable angina for many years and has
annual physical
checkups and ECGs at the cardiologist’s office. He took up the
hobby of downhill
skiing at the age of 66, with his cardiologist’s approval. He is
a retired accountant
with a type A personality. Over the past 6 months, he has
experienced infrequent
periods of lightheadedness. He has “blacked out” on at least one
occasion and
was unable to remember any details of what happened. A second
episode of loss
of consciousness occurred on a clear, cold winter day while he
was skiing. He
revived spontaneously. The next day, he scheduled an appointment
with his physician. The cardiologist performs an ECG and orders
bloodwork drawn for serum lipids, troponins, AST, CK and CK-MB, LDH
and isoenzymes, serum potassium, and C-reactive protein. The
patient is scheduled for an inpatient cardiac catheterization. The
physician tells him that, based on the findings at the time of the
catheterization, he may go ahead and perform an angioplasty.
(2) list two assessments and
the Rationale for each assessment.