Cardiovascular

at
Categories
Tags

Mr. W.G. is a 53-year-old white man who began to experience chest discomfort while playing tennis with a friend. At first, he attributed his discomfort to the heat and had a large breakfast. Gradually, however, discomfort intensified to a crushing sensation in the sternal area and the pain seemed to spread upward into his neck and lower jaw. The nature of the pain did not seem to change with deep breathing. When Mr. G. complained of feeling nauseated and began rubbing his chest, his tennis partner was concerned that his friend was having a heart attack and called 911 on his cell phone. The patient was transported to the ED of the nearest hospital and arrived within 30 minutes of the onset of chest pain. En route to the hospital, the patient was placed on a nasal cannula and an IV D5W was started. Mr. G. received aspirin (325 mg PO) and 2 mg/IV morphine. He is allergic to meperidine (rash). His pain has eased slightly in the last 15 minutes but is still significant; was 9/10 in severity; now7/10. In the ED, chest pain was not relieved by 3 SL NTG tablets. He denies chills.
Case Study 2 Questions:

For patients at risk of developing coronary artery disease and patients diagnosed with acute myocardial infarction, describe the modifiable and non-modifiable risk factors.
What would you expect to see on Mr. W.G. EKG and which findings described in the case are compatible with the acute coronary event?
Having only the opportunity to choose one laboratory test to confirm the acute myocardial infarction, which would be the most specific laboratory test you would choose and why?
How do you explain that Mr. W.G’s temperature has increased after his Myocardial Infarction, when can that be observed, and for how long? Base your answer on the pathophysiology of the event.
Explain to Mr. W.G. why he was experiencing pain during his Myocardial Infarction. Elaborate and support your answer.

 

 

Sample Solution

When discussing the risk factors associated with coronary artery disease (CAD) and acute myocardial infarction (AMI), it is important to consider both modifiable and non-modifiable factors. Non-modifiable risk factors are those which cannot be changed such as age, sex, race or genetics whereas modifiable risks refer to elements which can be managed through lifestyle changes or other interventions (Yusuf et al., 2009).

Non-modifiable risks for CAD/ AMI include being male, advancing age, a family history of the condition, certain genetic markers such as APOE4 gene variants in individuals of European descent, and ethnic background such as African Americans who have higher rates overall (Birnbaum & Krumholz 2017). Modifiable risks include obesity and lack of physical activity, smoking status, unhealthy dietary choices leading to high blood pressure or cholesterol levels such as an excessive intake of salt or saturated fat , alcohol consumption and stress levels (Go et al., 2019). Thus it is important to identify these factors early on in order to develop preventive strategies that reduce one’s chances of developing either condition in the future overall.

up with a hypothesis, alongside pioneers today including Frowe (2011). Their hypothesis is formulated as an aide, regardless of whether we ought to do battle alongside conditions which should be thought of, how would it be a good idea for us we respond and not do during a conflict in the event that it is unavoidable, lastly what further move ought to be made later. To assess this hypothesis, one should take a gander at the suspicions made towards it, for instance, entertainers which scholars forget about and the delay between conventional scholars and innovators. In particular, there can be no conclusive hypothesis of the simply war, in light of the fact that everyone has an alternate understanding of this hypothesis, given its normativity. In any case, the hypothesis gives a harsh presentation of how we ought to continue in the midst of pressure and struggle, essentially the point of a simply war: ‘harmony and security of the district’ (Begby et al, 2006b, Page 310). Generally, this hypothesis is reasonable to utilize yet can’t at any point be viewed as a characteristic aide since it’s normatively conjectured. To respond to the inquiry, the exposition is involved 3 segments.

Jus promotion bellum
The beginning segment covers jus promotion bellum, the circumstances discussing whether an activity is legitimately OK to cause a conflict (Frowe (2011), Page 50). Vittola, first and foremost, examines one of the worthwhile motivations of war, in particular, is when damage is caused however he causes notice the damage doesn’t prompt conflict, it relies upon the degree or proportionality, one more condition to jus promotion bellum (Begby et al (2006b), Page 314). Frowe, nonetheless, contends the possibility of “worthy motivation” in light of “Power” which alludes to the security of political and regional privileges, alongside common freedoms. In contemporary view, this view is more convoluted to reply, given the ascent of globalization. Essentially, it is hard to gauge proportionality, especially in war, in light of the fact that not just that there is an epistemic issue in working out, yet again the present world has created (Frowe (2011), Page 54-6). Besides, Vittola contends war is fundamental, not just for protective purposes, ‘since it is legal to oppose force with force,’ yet in addition to battle against the treacherous, a hostile conflict, countries which are not rebuffed for acting unreasonably towards its own kin or have shamefully taken land from the home country (Begby et al (2006b), Page 310&313); to “show its foes a thing or two,” yet principally to accomplish the point of war. This approves Aristotle’s contention: ‘there should be battle for harmony (Aristotle (1996), Page 187). Nonetheless, Frowe contends “self-preservation” has a majority of portrayals, found in Part 1, demonstrating the way that self-protection can’t necessarily legitimize one’s activities. Much more risky, is the situation of self-protection in war, where two clashing perspectives are laid out: The Collectivists, a totally different hypothesis and the Individualists, the continuation of the homegrown hypothesis of self-preservation (Frowe (2011), Page 9& 29-34). All the more critically, Frowe discredits Vittola’s view on retribution in light of the fact that right off the bat it enables the punisher’s power, yet additionally the present world forestalls this activity between nations through lawful bodies like the UN, since we have modernized into a generally tranquil society (Frowe (2011), Page 80-1). Above all, Frowe further disproves Vittola through his case that ‘right goal can’t be blamed so as to take up arms in light of expected wrong,’ recommending we can’t simply hurt another in light of the fact that they have accomplished something unfair. Different elements should be thought of, for instance, Proportionality. Thirdly, Vittola contends that war ought to be stayed away from (Begby et al (2006b), Page 332) and that we ought to continue conditions carefully. This is upheld by the “final retreat” position in Frowe, where war ought not be allowed except if all actions to look for strategy falls flat (Frowe (2011), Page 62). This implies war ought not be pronounced until one party must choose the option to proclaim battle, to safeguard

This question has been answered.

Get Answer