CASE STUDY SCENARIO Mr. BA is a 65 –year-old, African Canadian male from Brampto

Question

CASE STUDY SCENARIO

Mr. BA is a 65 –year-old, African Canadian male from Brampton, Ontario, Canada. He came to the Emergency Department with his wife of 30 years. Mr. BA was sent to the Emergency Department by his primary healthcare provider because “he has not been feeling well” for the past few days. He describes fullness in his head and chest without any associated symptoms. His medical history is pertinent only for primary hypertension, and he states that he ran out of his medication 2 weeks before he started experiencing symptoms.

Physical examination reveals an anxious man with a BP of 230/130 mm Hg with a heart rate of 108 bpm. Respirations are mildly elevated at 22 breaths per minute. No papilledema is seen on funduscopic examination. Lungs have bilateral rales one quarter up from the bases. Cardiac examination reveals a regular tachycardic rhythm with normal S1 and S2. Jugular venous pressure is normal but demonstrate sustained fullness with abdominal pressure. Apical pulse is prominent. No pedal edema, or abdominal bruits detectable. Peripheral pulses are equal.

Laboratory test results reveal normal CBCs, electrolytes, and renal functions. Several erythrocytes are seen in the urine. Oxygen saturation is 89% on room air. A 12-lead EKG shows sinus tachycardia, left axis deviation, 4-6mm ST-segment depression across the pericardium. A chest X-ray is significant for moderate pulmonary venous congestion and cardiomegaly.

The findings indicate that patient is in hypertensive crisis and in need of immediate medical attention and he is very anxious. BA is 5 feet 8 inches tall and weighs 200 pounds. He reports no form of regular exercise or special diet. BA’s diet entails carbohydrate dense foods, salted cod fish, bacon, goat meat, and high glycemic index beverages. BA smoke half pack of cigarette for the past five years and drinks a case of beer on weekends. BA father died of a heart attack at age 60. Brother had a stroke at age 50.

PART 1: Questions

Explanation / Answer

The long term complications of hypertension includes-

1) high blood pressure- the person suffered from the hypertension will have a high bp, it may be due to diet or living lifestyle etc.

2) jugular veins sustained fullness- due to hypertension the arteries and veins become hard and thicker due to which they show this type of fullness.

3) heart attack or stroke- the person with hypertension will be at a great risk of stroke or heart attack due to high bp

Refrences- new York times 27 Jan 2013

Www.CDC.gov>blood pressure>effects

Www.edarbi.com>risks

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