Question

Patricia is 56 years of age, she has had essential mild hypertension for 30 years that is stabilized by using ACE inhibitors. Her mother is 82, is alive and doing well but had experienced an myocardial infarction at 52 years of age. Both her mother and aunt are treated for hypertension and hypercholesterolemia. She is 30 pounds overweight but takes care of her diet and exercise 30 minutes everyday. She does not smoke or drink alcohol. She is on hypercholesterolemia medications and her lipid profile is good and stable. Her EKG and echocardiogram show normal heart imaging.

1. What are Patricia's risk factors for cardiac diseases?

2. What are the positive things that Patricia has in her lifestyle?

3. What are LDL & HDL and how do they affect the blood vessels?

4. What are the normal values of LDL and HDL in the blood?

5. What can an EKG show?

6. What can an echocardiogram tell the doctor about the structure of the heart?

7. What other tests can the doctor perform?

8. Describe the signs and symptoms of a myocardial infarction.

9. What recommendations would be given to Patricia?

Answer 1

1.The risk factor for Patricia are as:

• High blood pressure is the most important factor for cardiac disease.
• Family history is also the cause of cardiac disese for Patricia(because her mother and aunte is hypertensive).

2. Positive things in Patricia lifestyle are as follows:

• Maintaining/increasing physical activity.
• She don't smoke ,and maintaining good body weight.
• Taking medication regularly.

3. LDL: Low density lipoproteins,also called bad cholesterol because it takes cholesterol directly to your arteries and get deposited in the arteries.

HDL: It is also called good cholesterol because HDL carries cholesterol to your liver where it is removed from your blood stream before it built up in the arteries that prevents plaque formation in the arteries.

4. Normal values of LDL and HDL are as follows:

• Total cholesterol: 125 to 200mg/dl
• Non HDL: less than 130mg/DL
• LDL: less than 100mg/DL
• HDL: 50md/dl or greater.

5. Electrocardiography (EKG) is a test that checks how your heart is functioning ,by measuring the electrical conductivity of the heart.

At every heart beat electrical impulse travel through your heart.

In increased cholesterol level their is prolonged QT- interval in ECG.

6. ECG shows us how your heart is functioning, and it also shows us electrical conductconducof heart. Sino-atrial node(S.A node)/pacemaker of heart is responsible for conductivity of heart.

7. Other test used by doctor are as follows:

• Echocardiogram: used for conductivity of heart.
• Stress echocardiogram: to know how well your your heart and blood vessels are working.
• Abdominal USG: Used to visualize inferior venacava,superior venacava,Aorta etc.
• Cardiac catheterization: used to know how well your heart is functioning.

Holter monitor: Used to keep your heart rhythm properly.​​​​​​​

8. Signs and symptoms of myocardial infarction are as follows:

• Pain in the chest,neck,arms
• Fatigue
• Abnormal heart beat.
• Anxiety
• sweating
• lightheadedness.

9. Recommendations given to Patricia are as follows:​​​​​​​

• Avoid stressful conditions.
• Avoid fatty food mainly( Low density lipoproteins )
• Maintain body weight by daily exercises.
• Take medications at regular intervals
• Check blood pressure regularly.