Case Study Analysis of a 55-year-old high School Teacher Experiencing a Cough

The case scenario analyzed involves a 55-year-old high school teacher who began experiencing a cough after a parent-teacher conference. He reported that he initially experienced a mild cough, which later became intense, and he developed severe symptoms, including chest tightness and pain, sweating, light-headedness, and difficulty breathing despite using his inhaler. He passed out while driving and was picked up by paramedics. His EKG revealed ST segment elevation in the anterior leads (V3 and V4). His pulse and respirations were shallow and slow. At the ER, his troponin level was at 13ng/l, and his CK level was at 265 U/L.

The Cardiovascular and Cardiopulmonary Pathophysiologic Processes Resulting in Presented Symptoms

The symptoms that the patient presents, especially chest tightness and pain, sweating, light-headedness, and difficulty breathing, and diagnostic findings from the ER are consistent with an acute myocardial infarction (AMI). The underlying cardiovascular and cardiopulmonary pathophysiologic processes that result in the presented symptoms include a suppressed supply of oxygen to the heart muscles, mostly due to a blockage or narrowing of the coronary artery. The elevated levels of CK at 265 U/L and troponin indicate possible muscle damage, presumably to the heart and surrounding muscles. This means that the heart is not able to pump sufficient blood and oxygen to the critical systems, including the heart itself, the brain, and the respiratory system. The shallow pulse and slowed respirations are further evidence of low blood and oxygen supply to the body’s systems. This is a risk factor for heart muscle cell damage and death, resulting in the symptoms of a myocardial infarction (Yucel, 2022).

Possible Racial/ethnic Variables that may Impact Physiological Functioning

Genetic and ethnic factors may significantly influence physiological functioning, especially cardiovascular and cardiopulmonary functioning. Notable differences in an individual’s genetic structure influence how essential proteins and chemicals control how cardiovascular and cardiopulmonary systems perform their functions. This means an individual’s genes can lead to incorrect formation of such proteins and chemicals, resulting in impaired functioning of the systems. Evidence shows that there is a significant genetic predisposition to developing a heart attack and cardiovascular disease, among other diseases (Lello et al., 2019). Notably, certain ethnicities are more genetically predisposed to developing cardiovascular and cardiopulmonary functioning complications. For instance, race is a factor for increased high-sensitivity C-reactive protein (hs-CRP), insulin resistance, and cardiometabolic issues and the development of related diseases, including CVD, diabetes, and related diseases (Lopez-Neyman et al., 2022).

How these Processes Interact to Affect the Patient

In this case, possible heart damage resulting in reduced blood and oxygen supply across the body may be responsible for the symptoms the patient presents. Noting that the patient has a history of asthma, which is majorly genetically inherited, may have covered for symptoms of any underlying cardiovascular issues, including a possible coronary artery disease (CAD). The underlying CAD may have led to reduced blood and oxygen supply to the heart, leading to the AMI. Additionally, the patient has also been using inhaled corticosteroids to manage his asthmatic condition. The prolonged use of inhaled corticosteroids is linked to exacerbation of symptoms in patients with underlying cardiovascular disease (Narendra & Hanania, 2020). The reduced heart efficiency can lead to reduced blood and oxygen delivery to vital organs, causing some of the symptoms such as light-headedness, sweating, and shortness of breath.

References

Lello, L., Raben, T. G., Yong, S. Y., Tellier, L. C. A. M., & Hsu, S. D. H. (2019). Genomic Prediction of 16 Complex Disease Risks Including Heart Attack, Diabetes, Breast and Prostate Cancer. Scientific Reports, 9(1). https://doi.org/10.1038/s41598-019-51258-x

Lopez-Neyman, S. M., Davis, K., Zohoori, N., Broughton, K. S., Moore, C. E., & Miketinas, D. (2022). Racial disparities and prevalence of cardiovascular disease risk factors, cardiometabolic risk factors, and cardiovascular health metrics among US adults: NHANES 2011–2018. Scientific Reports 2022 12:1, 12(1), 1–10. https://doi.org/10.1038/s41598-022-21878-x

Narendra, D., & Hanania, N. A. (2020). Impact of inhaled corticosteroids in patients with cardiovascular disease. ERS Monograph, 2020(9781849841191). https://doi.org/10.1183/2312508X.10028719

Yucel, C. (2022). Cardiac biomarkers: definition, detection, diagnostic use, and efficiency. In The Detection of Biomarkers: Past, Present, and the Future Prospects. https://doi.org/10.1016/B978-0-12-822859-3.00007-9

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Question

To prepare:

By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Announcements” section of the classroom for your assignment from your Instructor.

Case Study Analysis of a 55-year-old high School Teacher Experiencing a Cough

The Assignment

In your Case Study Analysis related to the scenario provided, explain the following

The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms.
Any racial/ethnic variables that may impact physiological functioning.
How do these processes interact to affect the patient?