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A 21 year old male presents to the ED with stable angina. He underwent a full...

A 21 year old male presents to the ED with stable angina. He underwent a full cardiac workup, and was ultimately found to have multivessel CHD. In summary, the presence of mild dyslipidemia, high blood pressure, cigarette smoking, obesity, and a family history was sufficient to induce ischemic heart disease at such a young age.


a. What lifestyle modifications would you recommend to this client? List 3

b. What does the cardiac workup (i.e diagnostics or labs) consist of? List 3

c. What are potential complications for this client? List 3.

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Answer

1.Lifestyle modifications  to Manage Coronary Artery Disease (CHD)

  • Dietary Changes

Diets that are high in saturated fat and cholesterol increase your risk of CAD. Saturated fat and cholesterol are found in animal products, full-fat dairy products, lard, and palm and coconut oils, among other foods. These foods contribute to build up of plaque.

A dietitian can help you reduce saturated fats and cholesterol in your diet and teach you how to make healthier substitutions.

Good dietary choices include fresh fruits and vegetables, as well as lean meats and fish—particularly fish rich in omega-3 fatty acids such as salmon.

Decreasing low-density lipoprotein (LDL) cholesterol intake while increasing high-density lipoprotein (HDL) cholesterol intake may improve blood flow to the heart by reducing the amount of plaque in your arteries. Limiting fat and cholesterol in your diet can also help you lose weight.

  • Exercise Regularly

Note —Do not begin any exercise program without consulting your doctor.

Regular aerobic training can help increase your physical abilities and quality of life. You should aim to exercise for at least 30 minutes per day on most days of the week. Begin slowly and work your way to this goal. Depending on the symptoms and severity of your condition, your doctor may have you do an exercise test before starting a program.

  • Quit Smoking

Smoking damages your blood vessels and lung tissue, reduces the amount of oxygen in your blood, and forces your heart to beat faster. Talk to your doctor about the best way to quit smoking . Remember that secondhand smoke is also harmful. Make sure you are not exposed to cigarette smoke if at all possible. Not smoking improves blood flow by relaxing constricted blood vessels.

  • Reduce or Avoid Excess Weight

Excess weight strains the heart muscle and is associated with increased risk of atherosclerosis. If you are overweight, talk with a dietitian who can help you with portion control and meal planning. To achieve your goal weight, you should also participate in regular exercise most days of the week.

2.Cardiac Workup

  • Electrocardiogram (ECG)
  • Pharmacologic Stress Testing-Dipyridamole-Isotope Scintigraphy (DIS) and Dobutamine Stress Echocardiography (DSE)
  • Echocardiography
  • Cardiac Catheterization

3.Potential complications

  • · Chest pain (angina). When your coronary arteries narrow, your heart may not receive enough blood when demand is greatest — particularly during physical activity.
  • · Heart attack.
  • · Heart failure.
  • · Abnormal heart rhythm (arrhythmia).

Nightingale answered 1 year ago
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