A 47-year-old female patient with a history of mitral stenosis was admitted due to decreased in sensorium accompanied by fever, cough and worsening dyspnea. Manifestations started 3 days prior to consult (PTC) because of worsening dyspnea on small exertions accompanied by productive cough with purulent sputum but afebrile. She took her usual prescriptions given by her attending physician, Amiodarone, Furosemide, Losartan, Diltiazem and Carbocysteine which afforded temporary relief. A day PTC, she felt that dyspnea was worsening hence she booked an appointment with her physician. CVS Case At the OPD, while waiting for her turn to be examined, the patient was asymptomatic. The nursing attendant took her BP and was recorded at 110/80 mmHg and a heart rate of 89 bpm, RR was 23 bpm with no signs of dyspnea. After 2 hours, the secretary was calling her name but she was not replying. She was seen sitting on one side of the bench, stuporous with cold clammy extremities and was diaphoretic. She was immediately brought at the emergency department where she was managed. PE: Stuporous, responds when her name is called. BP = 80/50 mmHg, CR = 98 bpm (irregular), RR = 12 bpm, slightly labored, T° = 38.1°C; Wt = 63 Kg.; Height = 140 cms. Heart: Dynamic precordium, PMI at 6th ICS left anterior axillary line, (+) heaves, (+) thrills, (+) blowing holosystolic murmur at the 6th ICS MCL that radiates at the left axilla. Chest and Lungs: Asymmetrical chest expansion with lagging on the right, Increased tactile fremitus on both lung fields but more on the right, Dull on percussion on both basal lung fields. (+) coarse crackles are heard on both lung fields, (+) wheezing. Abdomen: Slightly globular, symmetric, normoactive bowel sounds, soft, tympanitic Extremities: (+++) bipedal edema, (+1) dorsalis pedis pulses. CXR Result: ECG Result: ave FD. A NOR T m n 42 va www Hrv ppppp grap v4
A 47-year-old female patient with a history of mitral stenosis was admitted due to decreased in sensorium accompanied by fever, cough and worsening dyspnea. Manifestations started 3 days prior to consult (PTC) because of worsening dyspnea on small exertions accompanied by productive cough with purulent sputum but afebrile. She took her usual prescriptions given by her attending physician, Amiodarone, Furosemide, Losartan, Diltiazem and Carbocysteine which afforded temporary relief. A day PTC, she felt that dyspnea was worsening hence she booked an appointment with her physician. CVS Case At the OPD, while waiting for her turn to be examined, the patient was asymptomatic. The nursing attendant took her BP and was recorded at 110/80 mmHg and a heart rate of 89 bpm, RR was 23 bpm with no signs of dyspnea. After 2 hours, the secretary was calling her name but she was not replying. She was seen sitting on one side of the bench, stuporous with cold clammy extremities and was diaphoretic. She was immediately brought at the emergency department where she was managed. PE: Stuporous, responds when her name is called. BP = 80/50 mmHg, CR = 98 bpm (irregular), RR = 12 bpm, slightly labored, T° = 38.1°C; Wt = 63 Kg.; Height = 140 cms. Heart: Dynamic precordium, PMI at 6th ICS left anterior axillary line, (+) heaves, (+) thrills, (+) blowing holosystolic murmur at the 6th ICS MCL that radiates at the left axilla. Chest and Lungs: Asymmetrical chest expansion with lagging on the right, Increased tactile fremitus on both lung fields but more on the right, Dull on percussion on both basal lung fields. (+) coarse crackles are heard on both lung fields, (+) wheezing. Abdomen: Slightly globular, symmetric, normoactive bowel sounds, soft, tympanitic Extremities: (+++) bipedal edema, (+1) dorsalis pedis pulses. CXR Result: ECG Result: ave FD. A NOR T m n 42 va www Hrv ppppp grap v4
Human Anatomy & Physiology (11th Edition)
11th Edition
ISBN:9780134580999
Author:Elaine N. Marieb, Katja N. Hoehn
Publisher:Elaine N. Marieb, Katja N. Hoehn
Chapter1: The Human Body: An Orientation
Section: Chapter Questions
Problem 1RQ: The correct sequence of levels forming the structural hierarchy is A. (a) organ, organ system,...
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Transcribed Image Text:A 47-year-old female patient with a history of mitral stenosis was admitted due to
decreased in sensorium accompanied by fever, cough and worsening dyspnea.
Manifestations started 3 days prior to consult (PTC) because of worsening dyspnea on
small exertions accompanied by productive cough with purulent sputum but afebrile. She took her
usual prescriptions given by her attending physician, Amiodarone, Furosemide, Losartan,
Diltiazem and Carbocysteine which afforded temporary relief. A day PTC, she felt that dyspnea
was worsening hence she booked an appointment with her physician.
CVS Case
At the OPD, while waiting for her turn to be examined, the patient was asymptomatic. The
nursing attendant took her BP and was recorded at 110/80 mmHg and a heart rate of 89 bpm, RR
was 23 bpm with no signs of dyspnea. After 2 hours, the secretary was calling her name but she
was not replying. She was seen sitting on one side of the bench, stuporous with cold clammy
extremities and was diaphoretic. She was immediately brought at the emergency department where
she was managed.
PE:
Stuporous, responds when her name is called. BP = 80/50 mmHg, CR = 98 bpm (irregular), RR
= 12 bpm, slightly labored, T° = 38.1°C; Wt = 63 Kg. ; Height = 140 cms.
Heart: Dynamic precordium, PMI at 6th ICS left anterior axillary line, (+) heaves, (+) thrills, (+)
blowing holosystolic murmur at the 6th ICS MCL that radiates at the left axilla.
Chest and Lungs: Asymmetrical chest expansion with lagging on the right, Increased tactile
fremitus on both lung fields but more on the right, Dull on percussion on both basal lung fields.
(+) coarse crackles are heard on both lung fields, (+) wheezing.
Abdomen: Slightly globular, symmetric, normoactive bowel sounds, soft, tympanitic
Extremities: (+++) bipedal edema, (+1) dorsalis pedis pulses.
CXR Result:
ECG Result:
ave
FD. A NOR
T m n
42
va
www
Hrv
ppppp
grap
v4
Transcribed Image Text:QUESTION: . Discuss the
cardiac cycle in relation with
the heart sounds. Correlate
with the patient's findings.
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