Within 30 minutes of presenting in the ED, Dr. Westwood developed bradycardia with a BP of 90/50 mmHg. Atropine was administered in response to the bradycardia. Intravenous hydration, gastric lavage, and activated charcoal followed a presumptive diagnosis of tetrodotoxin poisoning that was based on the clinical presentation in the ED. Five hours after treatment, the following vital signs were noted: • BP 125/79 mmHg • HR 78 bpm • Oxygen saturation: 97% on room air After discussing his case with his physician, he learned that he had probably been the victim of puffer fish poisoning. The active toxin in the tissues of this fish is a chemical called tetrodotoxin (TTX).
His initial medical diagnosis is heart failure (HF). Bert is immediately admitted to the acute care facility for further evaluation and treatment. Heart failure is called cardiac failure, pump failure, or congestive heart failure (CHF). It is defined as the inability of the heart to pump enough blood to meet the tissue's oxygen demands. Risk Factors Heart failure occurs most commonly in clients over the age of 60, and occurs more commonly in males than females.
4. A 68-year-old male presents to the office complaining of pronounced weakness on the right side of his body and slurred speech for the past 24 hours. Based on the examination, the physician orders an MRI to investigate a possible transient ischemic attack (TIA). The range of codes that would be used for this patient would be Codes 390-459 because the treating physician ordered and MRI to rule out a transient ischemic attack. These codes are for Diseases of the Circulatory System 5.
Case 2 - A 45 year old engineer presents to the ER complaining of a severe, intense, precordial, crushing sensation with pain radiating to the left shoulder and down the side of the left arm, triggered by exercise. the chest discomfort brought on by the exertion is relieved by rest. ER examination results in the following: 98 beats/min heart rate, BP of 160/110mmHg, and a respiratory rate of 24 breaths/min. EKG is performed and reveals ventricular extrasystole arrhythmia (premature ventricular contraction [PVC]) as well as ST segment depression and decreased R-wave height. Coronary angiography shows luminal obstruction >75% (91%) in three major coronary vessels, including the left anterior in ventricular (descending) coronary artery.
LDH-1 level higher than that of LDH-2 is indicative of a heart attack or injury. One of the most important diagnosis uses for the LDH isoenzymes test is in the different diagnosis of myocardial Infarction or heart attack. The total LDH level rises within 24-48 hours after a heart attack. Peaks in two to three days and returns to normal in approximately five to ten days. An LHD-1 level a phenomenon known as ‘flipped LDH’, Is strongly indicative of a Heart attack.
R included continuous cardiac monitoring with daily ECG’s as monitored in AF with frequent etopic beats, arrhythmias and right bundle branch block, daily bloods showed tropin rise with electrolyte imbalance, blood gasses showed severe metabolic acidosis with respiratory compensation, Trans thoracic echo to evaluate cardiac function, VQ scan for persistent shortness of breath and to rule out pulmonary embolism, oxygen 3 liters via nasal prongs to relieve shortness of breath, chest x-ray to see if pulmonary edema present, heparin infusion for infarct and until therapeutic level of >2 was reached, sublingual anginine for ongoing angina pain, low salt low fat diet, a not for resuscitation order was obtained from daughter who holds power of attorney, for pacing wires post 18 second run of asystoly Mr. R declined and requested no further surgical procedures or medical interventions to keep him alive. Ischemic dilated Cardiomyopathy, is defined as a disease of the heart muscle, the heart losses the ability to pump blood and the heart rhythm is disturbed leading to irregular heartbeats or arrhythmias. In most cases the exact cause of the muscle damage is never found. The dilated form occurs when disease affected muscle fibers lead to enlargement or dilation in one or more chambers of the heart. Therefore this weakens the heart’s pumping ability.
Retrieved from http://www.emedicinehealth.com/congestive_heart_failure/page5_em.htm Congestive Heart Failure (CHF) Treatment - Congestive Heart Failure - HealthCommunities.com. (n.d.). Retrieved from http://www.healthcommunities.com/congestive-heart-failure/treatment-chf_jhmwp.shtml Congestive Heart Failure: Types, Causes, & Treatment. (n.d.). Retrieved from http://www.healthline.com/health/congestive-heart-failure#Diagnosis5 Heart Failure Overview: MedlinePlus Medical Encyclopedia.
Task 7: Secondary prevention clinic This morning on the 17th September 2013 at the Hospital I attended the secondary prevention clinic, were patients with hypertension had to attend. One of the first patients to attend the clinic was a male and he is 49years. He was first presented to the hospital’s emergency department after an accident at work. This accident caused the patient to have two broken ankles which later lead to a myocardial infarction (MI) within a two hour period due to a possible ischaemic event within heart, suggesting ischemic heart disease. A clot busting drug Streptokinase was administered immediately to disperse the thrombus.
Data, Information, Knowledge, and Wisdom Congestive heart failure (CHF) is very serious chronic condition with a high mortality and morbidity rate among the elderly population. According to the Centers for Disease Control and Prevention, approximately 5.7 million people have heart failure and there are 550,000 million people newly diagnosed each year in the United States. In addition, approximately 287,000 deaths a year are related to heart failure (CDC, 2012). Today, ED physicians want to quickly and accurately identify patients with suspected CHF in order to confirm diagnosis, determine the cause, severity, and treatment. Brain natriuretic peptide (BNP) is a hormone in the blood that is secreted by the ventricles and atria in response to cardiac overload.
Case Study on Stroke Name: Institution: Case Study on Stroke Introduction Stroke, otherwise known as cerebrovascular accident, refers to a group of health conditions that occur as neurologic deficits caused by an abrupt interruption of cerebral blood flow. Put differently, a stroke results from a sudden decrease in the blood flow to the brain. An acute stroke is a term used in describing the initial twenty-four hours following a stroke event. Ischemic strokes, which results from embolisms or thrombosis, constitutes the vast majority of stroke cases (87 percent) while the remaining thirteen percent are hemorrhagic (resulting from aneurysm or the rupture of a blood vessel) (Yew & Cheng, 2009, p. 33). An ischemic stroke is usually characterized by a reduction or obstruction of blood supply to the brain due to blocked blood vessels caused by atherosclerosis or a blood clot.