Question

Tim goes to his family physician complaining of worsening angina, shortness of breath, and extreme fatigue. Tim is 5’11”, 240 lbs, and 68 years old. He has a history of smoking (one pack a day for 40 years), and is on the verge of Type II diabetes. Tim has been previously diagnosed with atherosclerosis, and has had bypass surgery to correct 2 blocked coronary arteries. A year ago, Tim had a heart attack and spent a couple of months in the hospital, during which he quit smoking. Tim is retired, and leads a virtually sedentary lifestyle. He goes for a walk with his wife one or two times a week when she drags him out, but lately he’s been too tired even to do that. He tries to watch what he eats – he avoids sweets most of the time, but still consumes a relatively high fat diet and has at least one beer every evening. He’s a bit concerned about his condition, but apart from the occasional chest pain and fatigue, claims that he feels “just fine”. Tim’s vitals at the doctor’s office are as follows: HR 90 bpm; slightly irregular BP 140/80 Respirations – slight tachypnea, shallow His last bloodwork revealed the following: Total cholesterol – 240 mg/dL HDL – 31 mg/dL LDL – 140 mg/dL Fasting glucose – 100 mg/dL Slightly elevated CRP Slight hypernatremia Further imaging has shown blockage in a new coronary vessel, and Tim wants to have another bypass surgery (this would mean he would have 3 total coronary arteries bypassed). What surgical treatment would you suggest for Tim at this point? Give 3 reasons for your answer. Explain how would each of the following improve Tim's cardiovascular health: Quitting smoking Eating a healthier diet and decreasing alcohol consumption Exercising Managing his diabetes What type of heart failure (left, right, or biventricular) is Tim at risk for developing? Explain your choice.

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Answer 1

1. In this point I suggest him go for angiography and stenting because he already had a two CABG.also advanced age also be of the reason to suggest the stenting to him.also medication therapy also suggested to him like beta blockers , calcium channel blockers etc.

2.How to quit smoking helps to improve the cardiovascular health means;

It thicken yours blood volume

Make blood vessels patent from the narrowing

It prevents the clotting.

Exercise helps to get better healthy heart ;

Areorobic exercise helps to reduce the blood pressure

Increases the HDL cholesterol

Decreased the LDL, TRIGLYCERIDES

IMPROVEMENT IN UTILIZATION OF GLUCOSE

REDUCE THE FAT .

DIABETIC CONTROL HELPS TO IMPROVE THE HEART HEALTH ;

It prevent the blood vessels getting blocked by maintaining the blood glucose level in normal

It will prevent the block in the arteries

It helps to maintain the heart lung performance effectively...

Heart failure is

Biventricular heart failure because first left heart failure occurs means it leads to the right side heart failure to them.