G.L. is a 56-year-old man who fainted while exercising. He reports having heart palpitations, chest pain,...
Fantastic news! We've Found the answer you've been seeking!
Question:
Transcribed Image Text:
G.L. is a 56-year-old man who fainted while exercising. He reports having heart palpitations, chest pain, shortness of breath, and fatigue, all of which are often precipitated by increased exertion. Symptoms may last an hour or more, compelling him to remain inactive until they stop. Physical Exam: • Average body frame. Height = 6'2"; Weight = 250 pounds • Heart Rate = 80 bpm (normal = 70 bpm). • Heart sounds indicate a mid-systolic ejection murmur, heard best over the "aortic area" or right second intercostal space, with radiation into the right neck. S2 was weak and a prominent fourth heart sound ($4) was heard. • Blood pressure = 127/85; Respiration rate = 18 breaths/min (normal = 12-18 breaths/min) Blood Tests for G.L. Cardiac Troponin I G.L.'s values Normal values Cardiac Troponin I (cTnl) 0.01 ng/mL <0.1 ng/mL Echocardiogram • GLs physician orders an echocardiogram to look for potential causes of his symptoms. Hs physkcian notes a thickened aortic valve and left ventricle hypertrophy. Normal echocardiogram: ght ventricle (RV); interventricular septum pvs), aoric valve (AV): let ventricle (LV): mitral valve (MV): ieft atrum (LA). QL'S echocardiogram: interventricuiar septum (IVS): aortie valve (Aov) let ventricie: (LV): meral valve (MV). left atrum (LAI. Echocardiogram of normal heart Echocardiogram of G.L's heart Exercise stress tost for G.L: Positive: Chest pain reproduced. ST depression noted on EKG. EKG for G.L. taken while exercising indicates left ventricular hypertrophy with inverted T wave. Nomal EKG GLSEKG 1 mv 10s Questions: 1. What is indicated by the heart murmur, diminished S2, and presence of S4 heart sounds? 2 Examine the patient's cardiac troponin test results. What does this resut tell you about his condition? 3. What is the most likely cause of GL's chest pain (angina or an acute myocardial infarction)? What evidence led you to this conclusion? 4. What is the final diagnosis of G.L's hoart condition (name the diseasej? What evidence led you to that conclusion? & Describe how G.L's condition caused syncope following exercise. 6 What is left ventricular hypertrophy? Why would G.L.'s condition lead to left ventricular hypertrophy? 7. What does the invarted Twave indicate? Why does it appoar only when the patient exercises? a What is the typical troatment for G.L's condition? G.L. is a 56-year-old man who fainted while exercising. He reports having heart palpitations, chest pain, shortness of breath, and fatigue, all of which are often precipitated by increased exertion. Symptoms may last an hour or more, compelling him to remain inactive until they stop. Physical Exam: • Average body frame. Height = 6'2"; Weight = 250 pounds • Heart Rate = 80 bpm (normal = 70 bpm). • Heart sounds indicate a mid-systolic ejection murmur, heard best over the "aortic area" or right second intercostal space, with radiation into the right neck. S2 was weak and a prominent fourth heart sound ($4) was heard. • Blood pressure = 127/85; Respiration rate = 18 breaths/min (normal = 12-18 breaths/min) Blood Tests for G.L. Cardiac Troponin I G.L.'s values Normal values Cardiac Troponin I (cTnl) 0.01 ng/mL <0.1 ng/mL Echocardiogram • GLs physician orders an echocardiogram to look for potential causes of his symptoms. Hs physkcian notes a thickened aortic valve and left ventricle hypertrophy. Normal echocardiogram: ght ventricle (RV); interventricular septum pvs), aoric valve (AV): let ventricle (LV): mitral valve (MV): ieft atrum (LA). QL'S echocardiogram: interventricuiar septum (IVS): aortie valve (Aov) let ventricie: (LV): meral valve (MV). left atrum (LAI. Echocardiogram of normal heart Echocardiogram of G.L's heart Exercise stress tost for G.L: Positive: Chest pain reproduced. ST depression noted on EKG. EKG for G.L. taken while exercising indicates left ventricular hypertrophy with inverted T wave. Nomal EKG GLSEKG 1 mv 10s Questions: 1. What is indicated by the heart murmur, diminished S2, and presence of S4 heart sounds? 2 Examine the patient's cardiac troponin test results. What does this resut tell you about his condition? 3. What is the most likely cause of GL's chest pain (angina or an acute myocardial infarction)? What evidence led you to this conclusion? 4. What is the final diagnosis of G.L's hoart condition (name the diseasej? What evidence led you to that conclusion? & Describe how G.L's condition caused syncope following exercise. 6 What is left ventricular hypertrophy? Why would G.L.'s condition lead to left ventricular hypertrophy? 7. What does the invarted Twave indicate? Why does it appoar only when the patient exercises? a What is the typical troatment for G.L's condition?
Expert Answer:
Answer rating: 100% (QA)
1 Murmur is an abnormal heart sound which heard over the Herat areas which is due to heart valve problems S2 heart sound usually diminished or absent because the aortic valve is calcified or immobile ... View the full answer
Related Book For
Chemistry The Central Science
ISBN: 978-0321696724
12th edition
Authors: Theodore Brown, Eugene LeMay, Bruce Bursten, Catherine Murphy, Patrick Woodward
Posted Date:
Students also viewed these medical sciences questions
-
How would you feel about devoting an hour or more to quality circle meetings every week or so, on your own time? If your answer is, No Way, do you think this is a fair attitude on your part? Why or...
-
The weight and systolic blood pressure of 26 randomly selected males in the age group 25 to 30 are shown in the following table. Assume that weight and blood pressure are jointly normally...
-
The following table gives the systolic blood pressure (SBP), body size (QUET), age (AGE), and smoking history (SMK = 0 if a nonsmoker, SMK = 1 if a current or previous smoker) for a hypothetical...
-
Francis and Peter are in a partnership sharing profits and losses in the ratio 3:2. The following is their trial balance as at 30 September 2020. particulars D ebit C redit Buildings (cost: RM...
-
Will consumers accept or reject the notion of delivering advertising messages via cell phones and other portable devices? Examine the issues surrounding this emerging practice and formulate a...
-
The cost of unleaded gasoline in the Bay Area once followed an unknown distribution with a mean of $4.59 and a standard deviation of $0.10. Sixteen gas stations from the Bay Area are randomly chosen....
-
Liberty's stock has traded recently around \(\$ 44\) per share. Use your answer to question 9 to measure the company's price/earnings ratio. a. 36 b. 44 c. 1.00 d. 69
-
In mid-2015, Cisco Systems had a market capitalization of $130 billion. It had A-rated debt of $25 billion as well as cash and short-term investments of $60 billion, and its estimated equity beta at...
-
Brandon Oil Company recently purchased oil and natural gas reserves in a remote part of Alaska for $800,000. Brandon spent $10,000,000 preparing the oil for extraction from the ground. Brandon...
-
Describe how to apply stratified sampling to sample from the Credit Risk Data file based on the different types of loans. Implement your process in Excel to choose a random sample consisting of 10%...
-
Based on your review, you determined that specific polices related to incident reporting and physical safeguards need revising. Develop two separate policies, using the template below, to address the...
-
What is the global area design? What are its strengths and weaknesses?
-
What factors could conceivably cause a sharp decline in the number of new strategic alliances formed?
-
What are the four basic steps in establishing an international control system?
-
Why is financial control so important?
-
What are the three basic ways of managing a strategic alliance?
-
Suppose Sam and Cory are married and are deciding whether to use the filing status of Single or of Married filing jointly. Cory has a taxable income of $50,000 and Sam has a taxable income of...
-
Refrigerant-134a enters an adiabatic compressor as saturated vapor at 120 kPa at a rate of 0.3 m3/min and exits at 1-MPa pressure. If the isentropic efficiency of the compressor is 80 percent,...
-
Draw the two possible dipeptides formed by condensation reactions between leucine and tryptophan.
-
Predict whether the following reactions will be spontaneous in acidic solution under standard conditions: (a) Oxidation of Sn to Sn2+ by I2 (to form I-) (b) Reduction of Ni2+ to Ni by I- (to form I2)...
-
A 20.0-mL sample of 0.150 M KOH is titrated with 0.125 M HClO4 solution. Calculate the pH after the following volumes of acid have been added: (a) 20.0 mL, (b) 23.0 mL, (c) 24.0 mL, (d) 25.0 mL, (e)...
-
The root mean square value of a signal \(x(t), x_{\mathrm{rms}}\), is defined as \[x_{\mathrm{rms}}=\left\{\lim _{T ightarrow \infty} \frac{1}{T} \int_{0}^{T} x^{2}(t) d t ight\}^{1 / 2}\] Using this...
-
What are the various methods available for vibration control?
-
Fill in the Blank. The presence of unbalanced mass in a rotating disc causes ____________ .
Study smarter with the SolutionInn App