Case Study CAD Answers.docx - Case Study Coronary Artery...

  • No School
  • AA 1
  • clblmt82
  • 4
  • 67% (3) 2 out of 3 people found this document helpful

This preview shows page 1 - 2 out of 4 pages.

Case Study: Coronary Artery Disease Answers Scenario: 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), hypertension (HTN), and anemia. A cardiac catheterization done a year ago showed 50% stenosis of the circumflex 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 x-ray (CXR) showed cardiomegaly and a 12-lead ECG showed left bundle branch block (LBBB). Results of chemistries (blood studies) drawn at this time were as follows: Na 136 mmol/L, K 5.2 mmol/L, BUN 15 mg/dl, creatinine 1.8 mg/dl, glucose 82 mg/dl, Cl 95 mmol/L, CBC: WBC 4.4 thou/cmm, Hgb 10.5 g/dl, Hct 31.4%, and platelets 229 thou/cmm. (NOTE: The former mm3, for cubic millimeters is currently written Thou or thou/cmm.) This morning his daughter brought him to the clinic because he has had increased fatigue, significant swelling of his ankles, and shortness of breath (SOB) for the past 2 days. His vital signs (VS) are 142/83, 105, 18, and 97.9° F. 1. Knowing his history and seeing his condition this morning, what further questions are you going to ask J.M. and his daughter? Activity: What makes you tired? Do you sometimes feel like you can’t get your breath (SOB)?

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture