N.K., a 65-year-old male, complained of severe, Intense, precordial, crushing sensation with pain radiating to the...

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N.K., a 65-year-old male, complained of severe, Intense, precordial, crushing sensation with pain radiating to the left shoulder and down the inside of the left arm. Patient reported biking at he time of onset af chest pain. Emergency room examination resulted in the following information: Physical Exam • Average body trame. Height = 511"; Weight = 236 pounds • Heart Rate = 98 bpm (normal = 70 bpm)k Blood pressure = 160/110 mm Hg: • Respiration rate = 28 breathsimin (normal = 12-18 breathalmin) ER Blood Tests Cardiac Troponin I N.K.'s values Normal values Cardac Troponin I (eTnl) 28 ng/ml <0.1 ng/ml • An EKG in the ER showed an elevated ST segment. Coronary angiography showed luminal obstruction (>90%) in three major coronary vessels, including near complete obstruction of the left anterior interventricular (descending) caronary artery. Nitroglycerin, beta-blockers, and calcium channel blockers were administered as pharmacologic therapy. His cardiologist decides that a non-nvasive surgical procedure will be used as the first option to open the three obstructed arteries. • The following day an exercise tolerance test was performed to test the functional response of N.K. s heart to graded stress. This test gave an EKG showing ischemia and myocardial injury. Mid exertion resulted in chest pain, which was releved by sublingual nitroglycerin EKG results EKG in ER EKG one day after A wave normal or nearly normal- Twave peakad A wave ampitude diminshing Normal EKG ST segment elevated Development ST elevaton odO wave more marked Questions 1. Look up a Body Mass Index (BMI) chart. a What is the N.K's BMI? b. According to the chart what category does N.K. into? 2 Why was a Cardiac Troponin i test performed? What does NK.'s resuits indicate about his condition? 3. N.K.'s hoart rate is olevated. Why is this a common symptom associated with N.K.'s condition? 4. What does the presence of an clevated ST segment on N.K.'s ECG indicato about the condition of his heart? 5. What is the most likely dlagnosis for N.K. (angina or an acute myocardial infarction)? What key evidences led you to that conclusion? History: N.K. has Type ll diabetes, which he treats with a combination of medications (Merformin and Glipizide). Blood lipid tests were performed approximately 6-months previously, with results shown below: Blood lipids Serum cholesteral Triglycendes HOL LOL N.K.'s values 332 mg/di 264 mgidi 33 mg/dl 290 mgidi Normal values <200 mgid 200 mgid 45 mg/d 60-180 mgid 6. Examine the patient's history and blood lipid results. What do the results of these tests, in combination with his BMI, tell you about a possible cause of his condition? 7. What does the presence of a "Q wavo" an N.K.'s ECG (one day after admission to the ER) indicate about the condition of his heart? Caronary angiography shows the presence of plaques in three coronary vessels that limik blood flow by a. What minimally invasive procedure could be used to treat N.K.'s coronary artery disoase (atheroscierosis)? Describe the procedure and how it is done. N.K., a 65-year-old male, complained of severe, Intense, precordial, crushing sensation with pain radiating to the left shoulder and down the inside of the left arm. Patient reported biking at he time of onset af chest pain. Emergency room examination resulted in the following information: Physical Exam • Average body trame. Height = 511"; Weight = 236 pounds • Heart Rate = 98 bpm (normal = 70 bpm)k Blood pressure = 160/110 mm Hg: • Respiration rate = 28 breathsimin (normal = 12-18 breathalmin) ER Blood Tests Cardiac Troponin I N.K.'s values Normal values Cardac Troponin I (eTnl) 28 ng/ml <0.1 ng/ml • An EKG in the ER showed an elevated ST segment. Coronary angiography showed luminal obstruction (>90%) in three major coronary vessels, including near complete obstruction of the left anterior interventricular (descending) caronary artery. Nitroglycerin, beta-blockers, and calcium channel blockers were administered as pharmacologic therapy. His cardiologist decides that a non-nvasive surgical procedure will be used as the first option to open the three obstructed arteries. • The following day an exercise tolerance test was performed to test the functional response of N.K. s heart to graded stress. This test gave an EKG showing ischemia and myocardial injury. Mid exertion resulted in chest pain, which was releved by sublingual nitroglycerin EKG results EKG in ER EKG one day after A wave normal or nearly normal- Twave peakad A wave ampitude diminshing Normal EKG ST segment elevated Development ST elevaton odO wave more marked Questions 1. Look up a Body Mass Index (BMI) chart. a What is the N.K's BMI? b. According to the chart what category does N.K. into? 2 Why was a Cardiac Troponin i test performed? What does NK.'s resuits indicate about his condition? 3. N.K.'s hoart rate is olevated. Why is this a common symptom associated with N.K.'s condition? 4. What does the presence of an clevated ST segment on N.K.'s ECG indicato about the condition of his heart? 5. What is the most likely dlagnosis for N.K. (angina or an acute myocardial infarction)? What key evidences led you to that conclusion? History: N.K. has Type ll diabetes, which he treats with a combination of medications (Merformin and Glipizide). Blood lipid tests were performed approximately 6-months previously, with results shown below: Blood lipids Serum cholesteral Triglycendes HOL LOL N.K.'s values 332 mg/di 264 mgidi 33 mg/dl 290 mgidi Normal values <200 mgid 200 mgid 45 mg/d 60-180 mgid 6. Examine the patient's history and blood lipid results. What do the results of these tests, in combination with his BMI, tell you about a possible cause of his condition? 7. What does the presence of a "Q wavo" an N.K.'s ECG (one day after admission to the ER) indicate about the condition of his heart? Caronary angiography shows the presence of plaques in three coronary vessels that limik blood flow by a. What minimally invasive procedure could be used to treat N.K.'s coronary artery disoase (atheroscierosis)? Describe the procedure and how it is done.