Sara. is 72-year-old woman who is transported by ambulance to the hospital with

Question

Sara. is 72-year-old woman who is transported by ambulance to the hospital with dizziness, fainting, weakness, fatigue, nausea, sweating, shortness of breath, and indigestion pain (heartburn). These symptoms began about 2 hours ago and have become progressively worse since she arrived at the hospital. Her blood pressure is 200/100 mm Hg, and her pulse is 102 BPM and regular. Her lung sounds are clear. No murmur is noted on cardiac auscultation. Her electrocardiogram and cardiac enzyme levels are indicative of myocardial infarction (MI). Her history is significant for smoking for 20 years. She quit about 5 years ago. She says she has “always” had a high cholesterol level and she was told about 10 years ago that she was a “borderline diabetic.” Her mother had a “heart attack” at age 62. She is currently on a cholesterol-reducing drug and an antihypertensive drug. She takes these medications daily.

1. What are Sara’s risk factors?

2. How could you determine if the infarction is in a left versus right coronary artery?

3. What is the significance of having elevated cardiac enzymes?

4. What factors will impact this patient’s prognosis

Explanation / Answer

1). Sara was diagnosed with myocardial infarction. Her risk factors include,

2). The location of infarction can be determined by ECG (electrocardiogram). It is usually present in the left ventricle than a right ventricle

3). Although most of the cardiac markers are enzymes, non-enzymatic cardiac markers such as “troponin” are also used. The three primary cardiac markers are,

Troponin is an important cardiac marker in myocardial damage. The CK-MB test is used to measure the extension of infarction. Myoglobin is used to measure the reperfusion after ischemia.

4). The patient's prognosis is affected by the initiation of therapy, and the extension of damage caused during the infarction.

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