Myocardial Infarction

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Submitted By mslankford
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Myocardial Infarction
Mr. X., aged 55 years, arrives at the emergency department with severe chest pain. He appears very anxious, and his facial skin is cool and clammy. His blood pressure is 90/60, and his pulse around 90, weak, and irregular. He is given oxygen, and intravenous line is opened, and leads for ECG are attached. Blood is taken for determination of serum enzymes and electrolytes. Tentative diagnosis is myocardial infarction involving the left ventricle. His wife arrives and, in response to questions, indicates that her husband is a heavy cigarette smoker, prefers a diet of fried foods and meat (he is obese), and had complained periodically of indigestion, with brief episodes of epigastric pain. He also seemed to be more fatigued at night recently but was very busy at work. He was fearful of heart disease because his father had died of a heart attack. He had also noticed more fatigue and intermittent leg pain when playing golf recently. Generalized atherosclerosis is suspected.
1. List the high-risk factors for atherosclerosis in this patient’s history. The high-risk factors for the atherosclerosis in the patient’s history include smoking, obesity, and a diet high in cholesterol and animal fat. Other factors include past history of heart disease and heart attack

2. Describe how atherosclerosis caused myocardial infarction. Atherosclerosis caused myocardial infarction by causing a build up of plaque occurring in five different phases over time. Development of a fatty streak is first, low density lipoproteins adhere, MAC’s ingulf the LDL’s, smooth muscle infiltrates, fibroblasts produce a collagen cap, and finally, the cap tears and forms a lesion, forming a clot and finishing closure of the lumen.

3. It is suspected that the indigestion reported in the history was really angina. Explain how this pain may have occurred.…...

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