CASE STUDY A wyocardial Infarction ss vears, has been complaining of severe fati

Question

CASE STUDY A wyocardial Infarction ss vears, has been complaining of severe fatigue stion." Her son is quite concerned and decides to her to the emergency department. On arrival she appears anxious, and her facial skin is cool and clammy; her blood ressure is 90/60, and the pulse is around 90, weak, and irregu- r. She is given oxygen, an intravenous line is opened, and leads for ECG are attached. Blood is taken for determination of serum enzymes and electrolytes. Tentative diagnosis is myo- cardial infarction involving the left ventricle. Her son provides information that indicates Ms. X is a long-time smoker, has a stressful job as a high school teacher, is recently separated after 20 years of marriage, and is fearful of losing the family home. She has also seemed to be more fatigued and stopped going to about 18 months ago. She has begun to rely on "fast pizza and fried chicken and cooks infrequently. Her he gym

Explanation / Answer

1. RISK FACTORS FOR ATHEROSCLEROSIS :

2. HOW ATHEROSCLEROSIS CAUSES MYOCARDIAL INFARCTION :

In large and medium sized arteries, the tunica media is infiltrated with fibrous tissue and calcium. This causes the vessels to become dilated, inelastic and tortous. Loss of elasticity increases systolic blood pressure, and the pulse pressure. When small arteries (arterioles) are involved, their lumen is reduced because of a deposition of substance called hyaline material, which also reduces the elasticity of the vessel wall. Because these arteries are the main determinants of peripheral resistance and blood pressure. Damage to small vessels has a disproportionte effect on blood flow, leading to ischaemia of tissues supplied by affected arteries and causes myocardial infarction.

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