Topic for your Collaborative Learning Community (CLC) presentation is Cardiogenic shock in the setting of Aortic stenosis.
As a CLC team, create a 10-12 slide PowerPoint presentation (not including title and references slides) that addresses a patient scenario related to the assigned Diagnostic Readiness Test (DRT) topic. Prepare your presentation by addressing the following:
Provide a description of the topic.
Describe a patient scenario related to the topic.
Describe the incidence of diseases related to the patient scenario.
Discuss predisposing factors or risk factors associated with the patient scenario.
List subjective complaints consistent with the patient scenario.
Provide a detailed physical exam of the patient.
Discuss diagnostic tests that should be performed for the workup keeping in mind cost-effective care.
Provide three differential diagnoses.
Describe the management of the patient.
Discuss necessary consults, referrals, and follow-up suggestions for the patient.
Discuss geriatric, legal, or ethical considerations for the scenario.
Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.
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.
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
Cardiogenic Shock in the Setting of Aortic Stenosis
Description of the Topic
Cardiogenic shock refers to a life-threatening condition where the heart is unable to pump enough blood to meet the body’s demands. It is often caused by severe heart damage, such as a heart attack or heart failure. Aortic stenosis, on the other hand, is a condition characterized by the narrowing of the aortic valve, which can impede blood flow from the heart to the rest of the body.
When aortic stenosis progresses to a severe stage, it can lead to significant strain on the heart, ultimately resulting in cardiogenic shock. This presentation will explore the connection between aortic stenosis and cardiogenic shock, focusing on a patient scenario to illustrate the clinical implications and management strategies.
Patient Scenario
Mr. Johnson, a 70-year-old male, presents to the emergency department with severe shortness of breath, chest pain, and dizziness. He has a history of aortic stenosis, which has been progressively worsening over the past few years. Recently, he has experienced increased fatigue and exercise intolerance. Today, his symptoms have acutely worsened, prompting him to seek medical attention.
Incidence of Diseases Related to the Patient Scenario
The incidence of aortic stenosis increases with age and is commonly found in older individuals. It affects approximately 2-9% of adults over the age of 65, with a higher prevalence in males. Cardiogenic shock, although relatively rare, can occur as a complication of severe aortic stenosis.
Predisposing Factors or Risk Factors
Several factors can predispose individuals to develop severe aortic stenosis and subsequently cardiogenic shock. These include:
Age: Advanced age increases the risk of developing aortic stenosis.
Genetics: Certain genetic conditions, such as bicuspid aortic valve, can increase the risk.
Smoking: Smoking is associated with an increased risk of aortic stenosis.
Hypertension: High blood pressure can contribute to the development and progression of aortic stenosis.
Hyperlipidemia: Elevated cholesterol levels can contribute to the development of aortic stenosis.
Subjective Complaints Consistent with the Patient Scenario
Mr. Johnson presents with several subjective complaints that are consistent with severe aortic stenosis and cardiogenic shock:
Severe shortness of breath: This is due to fluid accumulation in the lungs as a result of reduced cardiac output.
Chest pain: Mr. Johnson may experience chest pain due to reduced blood flow to the heart muscle.
Dizziness: Inadequate blood supply to the brain can lead to dizziness or lightheadedness.
Detailed Physical Exam of the Patient
During the physical exam, the following findings may be observed:
Hypotension: Low blood pressure may be present due to reduced cardiac output.
Tachycardia: The heart may compensate by increasing its rate to maintain cardiac output.
Murmur: A harsh systolic murmur may be heard over the precordium due to aortic stenosis.
Crackles in the lungs: Fluid accumulation in the lungs can cause crackles during auscultation.
Jugular venous distention: Elevated jugular venous pressure may indicate fluid overload.
Diagnostic Tests for Workup
To confirm the diagnosis and guide treatment decisions, several diagnostic tests should be performed:
Echocardiography: This is the primary imaging modality to assess the severity of aortic stenosis and evaluate cardiac function.
Electrocardiogram (ECG): ECG can provide information about any concomitant arrhythmias or ischemic changes.
Chest X-ray: This can help identify signs of pulmonary congestion or other cardiac abnormalities.
Cardiac biomarkers: Blood tests to measure cardiac enzymes such as troponin can help identify any myocardial damage.
Differential Diagnoses
When evaluating Mr. Johnson, it is important to consider alternative diagnoses that could present similarly. The following differential diagnoses should be considered:
Acute myocardial infarction (heart attack)
Pulmonary embolism
Congestive heart failure exacerbation
Management of the Patient
The management of Mr. Johnson will involve both medical and interventional approaches:
Stabilization: Initial measures will focus on stabilizing Mr. Johnson’s condition by ensuring adequate oxygenation, fluid resuscitation if needed, and pain relief.
Medical therapy: Medications such as diuretics, vasopressors, and inotropic agents may be used to improve cardiac function and relieve symptoms.
Surgical intervention: Depending on Mr. Johnson’s overall health and severity of aortic stenosis, surgical options such as valve replacement may be considered.
Supportive care: Close monitoring in an intensive care setting is essential to manage fluid balance, blood pressure, and provide supportive care.
Consults, Referrals, and Follow-Up Suggestions
In addition to cardiology consultation for further evaluation and management, Mr. Johnson may require:
Cardiac Catheterization Lab: This will help assess coronary artery disease and identify any potential revascularization needs.
Cardiothoracic Surgery: Consultation with a cardiothoracic surgeon will be necessary if surgical intervention is deemed appropriate.
Rehabilitation Services: Following treatment, Mr. Johnson may benefit from cardiac rehabilitation to optimize his recovery and quality of life.
Geriatric, Legal, or Ethical Considerations
In this scenario, several geriatric considerations should be taken into account:
Advanced age: Mr. Johnson’s age may impact treatment decisions and overall prognosis.
Polypharmacy: Older adults often take multiple medications, which can increase the risk of drug interactions and adverse effects.
Shared decision-making: Considering Mr. Johnson’s values and goals of care is essential when determining appropriate management options.
Legal and ethical considerations include informed consent for surgical interventions, ensuring patient autonomy and respect for his wishes.
In conclusion, severe aortic stenosis can lead to cardiogenic shock, which requires prompt recognition and appropriate management. By understanding the patient scenario, conducting thorough diagnostic workup, and considering geriatric, legal, and ethical aspects, healthcare providers can optimize outcomes for patients like Mr. Johnson.
