Carotid Artery Diease

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Submitted By belenhochnadel
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Case Study 5—Coronary Artery Disease
It is midmorning on the cardiac unit where you work, and you are getting a new patient. G.P., a 60- year-old retired businessman, is married and has 3 grown children. As you take his health history, he tells you that he began feeling changes in his heart rhythm about 10 days ago. He has hypertension and a 5-year history of angina pectoris. During the past week he has had more frequent episodes of midchest discomfort. The chest pain has awakened him from sleep but does respond to NTG, which he has taken sublingually about 8 to 10 times over the past week. During the week he has also experienced increased fatigue. He states, “I just feel crappy all the time anymore.” A cardiac catheterization done several years ago revealed 50% occlusion of the right coronary artery (RCA) and 50% occlusion of the left anterior descending (LAD) coronary artery. He tells you that both his mother and father had CAD. He is taking amlodipine, metoprolol, lipitor, and baby ASA qd.

Setting: Hospital, outpatient cardiac rehabilitation
Index Words: coronary artery disease (CAD), hypertension, angina, lifestyle modification, medications, laboratory values, assessment, risk factors, pacemaker

1. What other information are you going to ask about his episodes of chest pain? [k]

P Precipitating events What events or activities precipitated the pain (e.g., argument, exercise, resting)?
Q Quality of pain What does the pain feel like (e.g., pressure, dull, aching, tight, squeezing, heaviness)?
R Radiation of pain Where is the pain located? Does the pain radiate to other areas (e.g., back, neck, arms, jaw, shoulder, elbow)?
S Severity of pain On a scale of 0 to 10 with 0 indicating no pain and 10 being the most severe pain you could imagine, what number would you give the pain?
T Timing When did the pain begin?...

2. What are common sites for…...

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