Tim goes to his family physician complaining of worsening angina, shortness of b
ID: 249082 • Letter: T
Question
Tim goes to his family physician complaining of worsening angina, shortness of breath, and extreme fatigue. Tim is 5’11”, 240 lbs, and 68 years old. He has a history of smoking (one pack a day for 40 years), and is on the verge of Type II diabetes. Tim has been previously diagnosed with atherosclerosis, and has had bypass surgery to correct 2 blocked coronary arteries. A year ago, Tim had a heart attack and spent a couple of months in the hospital, during which he quit smoking.
Tim is retired, and leads a virtually sedentary lifestyle. He goes for a walk with his wife one or two times a week when she drags him out, but lately he’s been too tired even to do that. He tries to watch what he eats – he avoids sweets most of the time, but still consumes a relatively high fat diet and has at least one beer every evening. He’s a bit concerned about his condition, but apart from the occasional chest pain and fatigue, claims that he feels “just fine”.
Tim’s vitals at the doctor’s office are as follows:
His last bloodwork revealed the following:
Further imaging has shown blockage in a new coronary vessel, and Tim wants to have another bypass surgery (this would mean he would have 3 total coronary arteries bypassed).
What surgical treatment would you suggest for Tim at this point? Give 3 reasons for your answer.
Quitting smoking
Eating a healthier diet and decreasing alcohol consumption
Exercising
Managing his diabetes
What type of heart failure (left, right, or biventricular) is Tim at risk for developing? Explain your choice.
Tim goes to his family physician complaining of worsening angina, shortness of breath, and extreme fatigue. Tim is 5’11”, 240 lbs, and 68 years old. He has a history of smoking (one pack a day for 40 years), and is on the verge of Type II diabetes. Tim has been previously diagnosed with atherosclerosis, and has had bypass surgery to correct 2 blocked coronary arteries. A year ago, Tim had a heart attack and spent a couple of months in the hospital, during which he quit smoking.
Tim is retired, and leads a virtually sedentary lifestyle. He goes for a walk with his wife one or two times a week when she drags him out, but lately he’s been too tired even to do that. He tries to watch what he eats – he avoids sweets most of the time, but still consumes a relatively high fat diet and has at least one beer every evening. He’s a bit concerned about his condition, but apart from the occasional chest pain and fatigue, claims that he feels “just fine”.
Tim’s vitals at the doctor’s office are as follows:
HR 90 bpm; slightly irregular
BP 140/80
Respirations – slight tachypnea, shallow
His last bloodwork revealed the following:
Total cholesterol – 240 mg/dL
HDL – 31 mg/dL
LDL – 140 mg/dL
Fasting glucose – 100 mg/dL
Slightly elevated CRP
Slight hypernatremia
Further imaging has shown blockage in a new coronary vessel, and Tim wants to have another bypass surgery (this would mean he would have 3 total coronary arteries bypassed).
What surgical treatment would you suggest for Tim at this point? Give 3 reasons for your answer.
Explain how would each of the following improve Tim's cardiovascular health:Quitting smoking
Eating a healthier diet and decreasing alcohol consumption
Exercising
Managing his diabetes
What type of heart failure (left, right, or biventricular) is Tim at risk for developing? Explain your choice.
5Explanation / Answer
1. In this point I suggest him go for angiography and stenting because he already had a two CABG.also advanced age also be of the reason to suggest the stenting to him.also medication therapy also suggested to him like beta blockers , calcium channel blockers etc.
2.How to quit smoking helps to improve the cardiovascular health means;
It thicken yours blood volume
Make blood vessels patent from the narrowing
It prevents the clotting.
Exercise helps to get better healthy heart ;
Areorobic exercise helps to reduce the blood pressure
Increases the HDL cholesterol
Decreased the LDL, TRIGLYCERIDES
IMPROVEMENT IN UTILIZATION OF GLUCOSE
REDUCE THE FAT .
DIABETIC CONTROL HELPS TO IMPROVE THE HEART HEALTH ;
It prevent the blood vessels getting blocked by maintaining the blood glucose level in normal
It will prevent the block in the arteries
It helps to maintain the heart lung performance effectively...
Heart failure is
Biventricular heart failure because first left heart failure occurs means it leads to the right side heart failure to them.