Wk 1 Discussion 6001
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South University, Savannah *
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Course
6001
Subject
Medicine
Date
Apr 3, 2024
Type
docx
Pages
2
Uploaded by amandakaypetty
The patient visited the clinic presenting with symptoms of exertional chest discomfort
that had occurred for the last three months and had continued despite the use of medication. She has a medical history of high cholesterol, high blood pressure, and diabetes, as well as a family history of heart disease. She also is obese with a BMI of 35.5. Obese subjects are more likely to have left ventricular hypertrophy, which can lead to an imbalance between the supply and demand of oxygen, which can cause chest pain. Additionally, the increased intra-abdominal pressure that comes with visceral adiposity puts subjects at risk for heartburn and reflux symptoms (Karason et al., 2003). She is currently not compliant with her medication regimen, which includes lisinopril 20mg and hydrochlorothiazide 25mg. Ms. Johnston rated her chest discomfort as a 6/10 on a 10-
point scale. She stated the pain only comes when she is "moving" with physical activity but goes away when she rests or drinks cold water. The patient described her discomfort as "burning and even tingling," but added that "it always goes away." She stated it's happened six times in the last week, compared to only one in the first. She also stated that she has some shortness of breath but denies any dizziness, fainting, n/v, or pain that radiates to the neck, mouth, or arm. Ms. Johnston’s physical exam should consist of vitals, auscultating of organs, breath, and heart sounds, as well as inspection of appearance for any abnormalities. An ECG should be performed as well. An ECG can provide hints about an enlarged heart, heart defects, and other heart problems. It can also help your healthcare provider determine whether decreased blood flow to the heart muscle is the cause of the chest pain (
Electrocardiogram (ECG or EKG) - Mayo Clinic
, 2022). Ms. Johnston is at a higher risk
of having an MI, which her father died of, due to her obesity and medical history.
Ms. Johnston will be advised to continue with her current prescribed medications and to follow up with labs such as a lipid profile after several weeks. This is important to monitor her risk for cardiovascular diseases. The lipid profile test contains the measurement of total cholesterol levels like HDL and LDL, as well as the presence of fats in the blood (
Cholesterol Test - Mayo Clinic
, 2024). This is important because she is at high risk for a cardiac problem based on her presenting complications and multiple medications. During the follow-up visit, she will be assessed for compliance with medications because it can lower the risk for possible complications that will arise with pre-existing conditions, help in controlling the disease, and improve health outcomes. The patient’s education will revolve around lifestyle changes, diet, engagement in physical activity, and avoidance of bad habits that the patient has.
References:
Cholesterol test - Mayo Clinic
. (2024, February 20). https://www.mayoclinic.org/tests-
procedures/cholesterol-test/about/pac-20384601#:~:text=Overview,and%20triglycerides
%20in%20your%20blood.
Electrocardiogram (ECG or EKG) - Mayo Clinic
. (2022, March 19). https://www.mayoclinic.org/tests-procedures/ekg/about/pac-20384983#:~:text=An
%20ECG%20done%20while%20you,defects%20and%20other%20heart%20problems.
Karason, K., Lindroos, A. K., Stenlöf, K., & Sjöström, L. (2003). Relief of cardiorespiratory symptoms and increased physical activity after surgically induced weight loss. Archives of Internal Medicine
, 160
(12), 1797. https://doi.org/10.1001/archinte.160.12.1797
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