Cardiovascular Health: A Critical Case Study Analysis

by | Jun 20, 2024 | Nursing

Cardiovascular
Mr. W.G. is a 53-year-old white man who began to experience chest discomfort while playing tennis with a friend. At first, he attributed his discomfort to the heat and having had a large breakfast. Gradually, however, discomfort intensified to a crushing sensation in the sternal area and the pain seemed to spread upward into his neck and lower jaw. The nature of the pain did not seem to change with deep breathing. When Mr. G. complained of feeling nauseated and began rubbing his chest, his tennis partner was concerned that his friend was having a heart attack and called 911 on his cell phone. The patient was transported to the ED of the nearest hospital and arrived within 30 minutes of the onset of chest pain. In route to the hospital, the patient was placed on nasal cannula and an IV D5W was started. Mr. G. received aspirin (325 mg po) and 2 mg/IV morphine. He is allergic to meperidine (rash). His pain has eased slightly in the last 15 minutes but is still significant; was 9/10 in severity; now7/10. In the ED, chest pain was not relieved by 3 SL NTG tablets. He denies chills.

Case Study Questions

For patients at risk of developing coronary artery disease and patients diagnosed with acute myocardial infarct, describe the modifiable and non-modifiable risk factors.
What would you expect to see on Mr. W.G. EKG and which findings described on the case are compatible with the acute coronary event?
Having only the opportunity to choose one laboratory test to confirm the acute myocardial infarct, which would be the most specific laboratory test you would choose and why?
How do you explain that Mr. W.G temperature has increased after his Myocardial Infarct, when that can be observed and for how long? Base your answer on the pathophysiology of the event.
Explain to Mr. W.G. why he was experiencing pain during his Myocardial Infarct. Elaborate and support your answer.

 

Sample solution

Dante Alighieri played a critical role in the literature world through his poem Divine Comedy that was written in the 14th century. The poem contains Inferno, Purgatorio, and Paradiso. The Inferno is a description of the nine circles of torment that are found on the earth. It depicts the realms of the people that have gone against the spiritual values and who, instead, have chosen bestial appetite, violence, or fraud and malice. The nine circles of hell are limbo, lust, gluttony, greed and wrath. Others are heresy, violence, fraud, and treachery. The purpose of this paper is to examine the Dante’s Inferno in the perspective of its portrayal of God’s image and the justification of hell. 

In this epic poem, God is portrayed as a super being guilty of multiple weaknesses including being egotistic, unjust, and hypocritical. Dante, in this poem, depicts God as being more human than divine by challenging God’s omnipotence. Additionally, the manner in which Dante describes Hell is in full contradiction to the morals of God as written in the Bible. When god arranges Hell to flatter Himself, He commits egotism, a sin that is common among human beings (Cheney, 2016). The weakness is depicted in Limbo and on the Gate of Hell where, for instance, God sends those who do not worship Him to Hell. This implies that failure to worship Him is a sin.


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God is also depicted as lacking justice in His actions thus removing the godly image. The injustice is portrayed by the manner in which the sodomites and opportunists are treated. The opportunists are subjected to banner chasing in their lives after death followed by being stung by insects and maggots. They are known to having done neither good nor bad during their lifetimes and, therefore, justice could have demanded that they be granted a neutral punishment having lived a neutral life. The sodomites are also punished unfairly by God when Brunetto Lattini is condemned to hell despite being a good leader (Babor, T. F., McGovern, T., & Robaina, K. (2017). While he commited sodomy, God chooses to ignore all the other good deeds that Brunetto did.

Finally, God is also portrayed as being hypocritical in His actions, a sin that further diminishes His godliness and makes Him more human. A case in point is when God condemns the sin of egotism and goes ahead to commit it repeatedly. Proverbs 29:23 states that “arrogance will bring your downfall, but if you are humble, you will be respected.” When Slattery condemns Dante’s human state as being weak, doubtful, and limited, he is proving God’s hypocrisy because He is also human (Verdicchio, 2015). The actions of God in Hell as portrayed by Dante are inconsistent with the Biblical literature. Both Dante and God are prone to making mistakes, something common among human beings thus making God more human.

To wrap it up, Dante portrays God is more human since He commits the same sins that humans commit: egotism, hypocrisy, and injustice. Hell is justified as being a destination for victims of the mistakes committed by God. The Hell is presented as being a totally different place as compared to what is written about it in the Bible. As a result, reading through the text gives an image of God who is prone to the very mistakes common to humans thus ripping Him off His lofty status of divine and, instead, making Him a mere human. Whether or not Dante did it intentionally is subject to debate but one thing is clear in the poem: the misconstrued notion of God is revealed to future generations.

 

References

Babor, T. F., McGovern, T., & Robaina, K. (2017). Dante’s inferno: Seven deadly sins in scientific publishing and how to avoid them. Addiction Science: A Guide for the Perplexed, 267.

Cheney, L. D. G. (2016). Illustrations for Dante’s Inferno: A Comparative Study of Sandro Botticelli, Giovanni Stradano, and Federico Zuccaro. Cultural and Religious Studies, 4(8), 487.

Verdicchio, M. (2015). Irony and Desire in Dante’s” Inferno” 27. Italica, 285-297.

Sample Answer

Sample Answer

 

Cardiovascular Health: A Critical Case Study Analysis

Introduction

Cardiovascular diseases, including coronary artery disease and acute myocardial infarction, are among the leading causes of morbidity and mortality worldwide. In this case study, we explore the medical emergency experienced by Mr. W.G., a 53-year-old man presenting with symptoms suggestive of an acute coronary event. Through an in-depth analysis, we aim to elucidate the risk factors, diagnostic approaches, and pathophysiological mechanisms underlying his condition.

Risk Factors for Coronary Artery Disease and Acute Myocardial Infarction

Modifiable Risk Factors:

– Hypertension: Uncontrolled high blood pressure can strain the heart and arteries.
– Hyperlipidemia: Elevated cholesterol levels contribute to atherosclerosis.
– Diabetes: Poorly managed diabetes increases the risk of cardiovascular complications.
– Smoking: Tobacco use accelerates atherosclerotic plaque formation.

Non-Modifiable Risk Factors:

– Age: Increasing age is a significant risk factor for cardiovascular diseases.
– Gender: Men are generally at higher risk for coronary artery disease at a younger age.
– Family History: Genetic predisposition plays a role in cardiovascular risk.

EKG Findings and Acute Coronary Event

On Mr. W.G.’s EKG, one would expect to see:

– ST-Segment Elevation: Indicates acute myocardial infarction.
– T-Wave Inversions: Can suggest ischemia or infarction.
– Q-Waves: Signify prior myocardial damage.

The crushing chest pain spreading to the neck and jaw, unrelieved by nitroglycerin, is compatible with an acute coronary event.

Specific Laboratory Test for Acute Myocardial Infarction

The most specific laboratory test to confirm acute myocardial infarction is Troponin. Troponin levels rise within hours of myocardial injury and remain elevated for an extended period, providing a reliable indicator of cardiac damage.

Temperature Changes after Myocardial Infarction

After a myocardial infarction, Mr. W.G.’s increased temperature can be attributed to the inflammatory response triggered by cardiac tissue damage. This fever may be observed for a few days post-infarction as part of the healing process.

Explanation of Pain during Myocardial Infarction

During a myocardial infarction, the intense chest pain experienced by Mr. W.G. is due to ischemia (lack of blood flow) and subsequent necrosis of cardiac muscle tissue. The release of inflammatory mediators and stimulation of pain receptors in the heart’s lining contribute to the severe, crushing pain characteristic of a heart attack.

In conclusion, the case study of Mr. W.G. underscores the critical nature of prompt recognition and management of acute coronary events. By understanding the multifaceted aspects of cardiovascular health, healthcare providers can effectively intervene to mitigate risks, diagnose accurately, and provide optimal care for patients experiencing cardiac emergencies.

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