Symptoms and Complication of Heart Failure Essay
You are working in the internal medicine clinic of a large teaching hospital. Today your first patient is 70-year-old J.M., a man who has been coming to the clinic for several years for management of coronary artery disease (CAD) and hypertension (HTN). A cardiac catheterization done a year ago showed stenosis of the circurnflex coronary artery. He has had episodes of dizziness for the past 6 months and orthostatic hypotension, shoulder discomfort, and decreased exercise tolerance for the past 2 months. On his last clinic visit 3 weeks ago, a chest -ray (CXR) examination revealed cardiomegaly, and a 12-lead electrocardiogram (ECG) showed sinus tachycardia with left bundle branch block (LBBB). You review J.M.’s morning blood work and initial assessment. Chart View Initial Assessment Complains of increased fatigue and shortness of breath, especially with activity, and “waking up gasping for breath” at night, for the past 2 days. 1. Indicate whether J.M.’s vital signs are normal or abnormal, indicate normal ranges, and explain your rationale for the change in Vital Signs. 2. As you review these results, which ones are of possible concern, and why?
Based on the patient’s laboratory results and initial assessment, the following results are possible concern:
1. Sinus tachycardia with LBBS on the 12 lead ECG. This suggest a possible electrical conduction problem in the heart and can indicate the presence of underlying heart disease. Symptoms and Complication of Heart Failure Essay
2. Cardiomegaly on the chest X-ray. This can indicate the presence of heart inlay cement, which can occur in cases of heart failure or other cardiac condition.
3. Orthostatic hypotension, dizziness, and decreased exercise tolerance for the past 2 months, along with shortness of breath and walking up gasping for breath at night for the past 2 days. These symptoms are concerning for possible heart failure, which can occur as a complication of CAD and HTN
4. Elevated heart rate(105 beats/min) and respiratory rate (18 breath/min). This can indicate the presence of heart failure or other cardiac conditions.
5. Low hemoglobin(11.5 g/dl) and hematocrit (37% ) levels. This can indicate the presence of anemia, which can be complication of heart failure or other underlying medical conditions.
6. Elevated creatinine level (0.8mg/dl) and elevated BUN level (82mg/dl). This can indicate the presence of kidney dysfunction, which can be a complication of heart failure or other underlying medical conditions.
Diagnosis based on the patients symptoms, laboratory results, and initial assessment is Heart failure.
The presence of sinus tachycardia with LBBS, cardiomegaly, orthostatic hypotension, dizziness, decrease exercise tolerance, shortness of breath, and walking up gasping for breath at night, along with elevated heart rate and respiratory rate, Lo hemoglobin and hematocrit levels, and elevated creatinine and BUN levels are all consistent with heart failure. Symptoms and Complication of Heart Failure Essay