Please help me answer the following clinical case questions. Please do not attem

Question

Please help me answer the following clinical case questions. Please do not attempt to answer unless you can answer all questions. Your help is greatly appreciated. Thank you.

A 61 year old AAF was admitted to the hospital with a worsening of abdominal pain, upset stomach with heartburn, nausea, and vomiting. The pain and symptoms started 2-3 days ago. The antacid medication made her well until the morning of this day. Physical examination shows tenderness of the RLQ of the abdomen, but soft and no rebound. An ECG shows numerous abnormal beats and marked deviation of the segment S-T. CPP was positive, showing troponin elevation, cardiac CK (creatine kinase), in addition to elevated blood glucose levels. Shortly after admission, she suffered cardiac arrest and died.

1. What is your diagnosis? Diverticulitis, Appendicitis, etc?

2. How is your diagnosis based on the physical examination and ECG?

3. What do the lab data demonstrate?

4. What has caused the cardiac arrest?

5. Are the starting and course of the disease typical or not? Explain.

6. Is it true that there is a "cardioptosis of old age"? The heart migrates down towards the abdomen with age.

Explanation / Answer

1 Depending on tenderness of the RLQ of the abdomen and symptoms it is diagonised as Diverticulitis common sympton is the abdominal pain.

2..In ECG ,ST segment depression is often a sign of myocardial ischemia or infraction , of which coronary insufficiency is a major cause.

3.Troponin elevation was defined to signify the extent of myocardial injury,Creatinine kinase value is increased during myocardial infraction,From ECG and lab data it is a massive myocardial infraction

4.Cardiogenic shock.

5.It may not be typical as it may differ with age,sex of the patient.

6. Cardioptosis is the downward displacement of the heart, up to date information is not available on this theory .

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