Cardiovascular Case Histories CASE 3 Due Thursday April 5, 8:00am A 50-year-old
ID: 3514868 • Letter: C
Question
Cardiovascular Case Histories CASE 3 Due Thursday April 5, 8:00am A 50-year-old airline pilot complained of severe, intense, precordial, crushing sensation with pain radiating to the left shoulder and down the inside of the left arm, triggered by an "off- duty" tennis match. The chest discomfort brought on by the exertion was relieved by rest, emergency room examination resulted in the following information: Heart rate (HR) Blood pressure (BP) ECG: ventricular extra systole arrhythmia (premature ventricular contraction [PVCI) as 98 b/min 160/110 mm Hg well as S-T segment depression and decreased R wave height The following day an exercise tolerance test was performed to test the functional response to graded stress. This symptom-limited test gave an "ischemic" ECG response during exercise, characterized by a downward-sloping S-T segment. Mild exertion resulted in chest pain, which was relieved by sublingual nitroglycerin. Coronary angiography showed luminal obstruction > 70% (88%) in three major coronary vessels, including the left anterior interventricular (descending) coronary artery. Nitroglycerin, beta-blockers, and calcium channel blockers were tried as pharmacologic therapy. Angioplasty, the procedure in which a balloon-tipped catheter is inserted into the partially obstructed vessels, was able to increase coronary flow to near normal values. QUESTIONS: What is the term for the chest pain experienced by this individual? What is the cause of this pain? (4 points) 1.Explanation / Answer
1. Angina pectoris (stable angina)
Cause of the pain:
The pain occurs when the heart muscle doesn't get enough blood (oxygen supply) to function properly. When the patient take exertion the heart work harder due reduced oxygen supply (ischemia) to heart muscle. Certain factors such as narrowing of artery (atherosclerosis) prevent the heart from getting more oxygen. The arteries become narrow and hard when plaque build up occurs inside the artery wall. This narrowing of arteries due to plaque accumulation (fat, cholesterol, calcium, other substances) results in reduced blood supply to heart muscle during exertion leads to pain (angina pectoris or stable angina)