Question

David, a 55 year old high school teacher is a heavy smoker with really poor eating habits. He was admitted to the ER a week ago because he was experiencing symptoms including shortness of breath, chest pain, weakness in his left arm and left leg. He was rushed to the Coronary Care Unit, where clinicians performed Electrocardiogram (ECG) and arteriogram tests. Results showed 80% occlusion of the left main coronary artery.

1. What condition does he have? a) dilated cardiomyopathy, b) atherosclerosis, c) myocardial infarction, d) cardiac arrhythmia, e) endocarditis

2. Which treatment is David most likely to receive for this condition?

3. What are the risk factors for this condition?

4. What are the underlying mechanisms (causes) that result in this condition?

Answer 1

1. Here, the main symptom to be seen here are chest pain and weakness in the left arm. These are typical signs of a heart attack whose medical term is Myocardial infarction. Moreover, ECG shows 80% occlusion proving the same.

2. Either streptokinase or tissue plasminogen activator coupled with Heparin is the first treatment methodology used. Aspirin would then be administered. Aspirin option will be purely based on the medical history of the patient and contraindications possible if any. Beta-blockers and ACE inhibitors are also found very much helpful in this situation.

3. Risk factors for this condition include Smoking, Hypertension, Obesity, Diabetes, High cholesterol levels

4. Smoking is the primary factor that has caused MI here. In fact, the chemicals of smoke which is inhaled in the lung pass through blood and will cause inflammation to the lining of the coronary artery. It will also lead to the formation of clots on the inner side of the artery which will increase with time. As time pass by occlusion % will continue to increase and when the level exceeds 80%, the myocardial ischemia or first sign of a heart attack occurs. 100% occlusion leads to the death of cardiac muscle tissues called Myocardial infarction. Here, it can be said as the beginning of myocardial infarction as well which can be fatal and would certainly need a bypass surgery.