A 54-year-old male patient arrives in the emergency department complaining of severe chest pain that radiates...

A 54-year-old male patient arrives in the emergency department complaining of severe chest pain that radiates to his mid-back along with dyspnea. He is morbidly obese, has smoked two packs of cigarettes a day for the past 20 years, and has two immediate family members who have died of heart disease.

1. What does the ED physician suspect is causing the patient’s symptoms?

2. What tests should the ED physician order?

3. Will surgical intervention be necessary, and if so, what procedure?

4. What procedure is typically attempted before surgery, where is that procedure performed, and by what type of physician specialist?

5. Describe what occurs when a patient experiences a mediastinal shift.

Solutions

Expert Solution

1. What does the ED physician suspect is causing the patient’s symptoms?

Myocardial infarction(Heart attack ).As the patient is having chest pain with radiation ,positive family history of heart attack and smoking habit ,likely to be Myocardial infarction.

2. What tests should the ED physician order?

ECG
Blood test for cardiac enzymes

3. Will surgical intervention be necessary, and if so, what procedure?

Surgical intervention decision will be depends on the cardiac catheterization study results.if major vessel or multiple vessel involvement for the MI.Then CABG-Coronary artery bypass graft is the surgical intervention .

4. What procedure is typically attempted before surgery, where is that procedure performed, and by what type of physician specialist?

If the patient is confirmed as an MI.Then coronary angiogram to be performed and if needed angioplasty to be done.It will be done in cardiac cath lab by an interventional cardiologist.

5. Describe what occurs when a patient experiences a mediastinal shift?

Mediastinal shift occurs when the mediastinal structures (Heart,great vessel,trachea and oesophagus) shifted or pushed to one side of the thoracic cavity .It is usually associated with pneumothorax associated with chest wall injury.Symptoms may be dyspnea,cyanosis,distended neck veins etc.

Nightingale answered 1 year ago

Next > < Previous

Related Solutions

A 50-year-old male patient arrives in the emergency department complaining of severe chest pain. He is...

A 50-year-old male patient arrives in the emergency department complaining of severe chest pain. He is taken to the cardiac cath lab for a coronary angiogram and left ventriculogram. The cardiologist discovers a lesion in the left main coronary artery branch and orders an immediate CABG. 1. What does the acronym CABG stand for? 2. Why does the location of this lesion make it more dangerous than lesions in other locations? 3. Could the cardiologist perform an angioplasty to repair...

1. A 55-year-old male arrives at the hospital complaining of chest pain, shortness of breath and...

1. A 55-year-old male arrives at the hospital complaining of chest pain, shortness of breath and dizziness. The attending physician suspects the patient may be suffering from a heart attack after confirming the patient’s history of coronary artery disease. a. Discuss the imaging technique (s) and/or hemodynamic data that can be used in a catheterization procedure to confirm stenosis in a coronary artery. b. If coronary artery stenosis is confirmed, discuss at least two (2) possible interventions that the interventional...

A patient with chest pain arrives in the emergency department. The staff hurries to perform a...

A patient with chest pain arrives in the emergency department. The staff hurries to perform a 12-lead electrocardiogram (ECG). The patient appears anxious and asks, “Why are all of these wires being hooked up to me?” Which of the following would be the best response by the nurse? Group of answer choices “The electrocardiogram wires will monitor your vital signs so we can see if there are any changes that require intervention.” “We are implementing this test to take the...

John is a 58 years male who arrives in the emergency department (ED) complaining of chest...

John is a 58 years male who arrives in the emergency department (ED) complaining of chest pain and tightness, loss of feeling in his left arm, nausea, shortness of breath, and fatigue. What questions the nurse will you ask the patient? What is the first task nurse will complete? What is the significance of taking John blood pressure, temperature, and pulse? Why would you hook John up to a heart monitor/EKG machine?

Case: Chest Pain F.C. is a 57-year-old male who presents to the emergency department with chest...

Case: Chest Pain F.C. is a 57-year-old male who presents to the emergency department with chest pain and shortness of breath. Subjective data: PMH: HTN, hyperlipidemia, coronary artery bypass graft 4 years ago secondary to myocardial infarction Sudden onset shortness of breath Crushing feeling, chest pain 10/10 Current smoker, 1 pack a day for 41 years Objective data: Vital signs: T 37 C, P 72, R 20, BP 144/64 Lungs: clear bilaterally O2 sat: 94% Skin: cool to touch CV:...

A patient is admitted to the emergency room of a hospital complaining of chest pain and...

A patient is admitted to the emergency room of a hospital complaining of chest pain and shortness of breath. Upon receiving the test results, it is determined that the individual is experiencing a myocardial infarction (MI). What anatomical changes occur during this condition, and what is/are the likely consequence(s)?

A 50 year old male presents to the ER complaining of severe pain in his left...

A 50 year old male presents to the ER complaining of severe pain in his left toe. The pain was sudden in onset and he describes the pain as sharp and non radiating. He is having difficulty bearing weight on his foot. His past medical history is significant for essential hypertension which is well controlled with an Ace inhibitor. Examination is significant for an inflamed first metatarsal phalangeal joint. In passing, he states that he enjoys a good meal, like...

A 35-year-old man presents to the emergency department with complaints of chest pain. The pain improves...

A 35-year-old man presents to the emergency department with complaints of chest pain. The pain improves by leaning forward. On review, he has noted a flu-like illness over the last several days including fever, runny nose and cough. Upon further investigation his blood test indicates signs/parameters for infection. He denies tobacco, alcohol or drug use. His head and neck examination is notable for clear mucus in the nasal passages. However, his jugular venous pressure is high. Also, during his cardiac...

1. A 32-year-old woman is seen in the emergency department complaining of a severe headache and...

1. A 32-year-old woman is seen in the emergency department complaining of a severe headache and nausea. She reports a history of headaches off and on for the past several months, typically unilaterally and without warning. In addition, she reports that the headaches occur at varying times of the day. A. Based on this brief history, the physician suspects that the woman may suffer from: A. CPH B. Tension type headaches (TTHs) C. Migraine headaches D. Cluster headaches 2. A...

A 58-year old male presents with a complaint of severe chest pain over the past hour....

A 58-year old male presents with a complaint of severe chest pain over the past hour. He did not call 911 “because I don’t have the money for an ambulance.” Discuss what questions you would ask the patient, what physical exam elements you would include, and what further testing you would want to have performed. In SOAP format, list: Pertinent positive and negative information Differential and working diagnosis Treatment plan, including: pharmacotherapy with complementary and OTC therapy, diagnostics (labs and...

Subjects