omprehensive Case Study Report This assignment addresses Course Outcomes: **Use relevant vocabulary, including anatomical positions, to describe human anatomy and physiology and the role of homeostasis and metabolism in the normal functioning of organ systems. **Apply knowledge of the chemical basis of life and biological processes to explain basic cell structure and function as it relates to the development of tissues and organs in anatomy and physiology.

omprehensive Case Study Report-Mrs. S

Section 1: Scenario

Description

Mrs. S is a 68-year-old African-American female with a medical history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). She is married and has three children. Despite requiring a nasal oxygen cannula when doing physical activities due to her COPD, she still smokes four packets of cigarettes daily. She has smoked for the last 48 years. She experienced flu-like symptoms like nausea, malaise, fever, and productive cough three days ago. He could not do any activities of daily living and required help to walk up the staircases. She is currently on nimodipine and hydrochlorothiazide for her hypertension. The patient was admitted to the intensive care unit for acute COPD exacerbation and acute decompensated heart failure.

Subjective Data

The patient was anxious during the interview, stating that she would die soon. She states that she always cries due to her pain. She feels like her heart is “running away” and complains that she is exhausted and cannot conduct daily activities without help. She also felt chest tightness. She feels she is a burden to others.

Objective Data

Vital signs: Ht 175cm  Wt 94 kg BMI: 30.7 T 38.7  HR 120   RR 36  BP 95/60

Cardiovascular: S1, S2 heard distantly. PMI below the sixth ICS and faint. Bilateral jugular vein distention. Peripheral edema.

Respiratory: Pulmonary crackles heard. Blood spilled sputum. SPO2 81%.

Gastrointestinal: Normoactive bowel sounds present. Hepatomegaly on palpation.

Section II: Patient Report

Diagnosis Name

The diagnosis for this patient is coronary heart disease (CHD).

Explanation

The patient has the risk factors for CHD. She is a post-menopausal woman, obese with a BMI of 30.7, has high blood pressure, and is a chronic smoker (Timmis et al., 2020). This increases her risk factor for getting CHD. The symptoms of CHD include chest aching, chest tightness, shortness of breath, and fatigue during exercise (Timmis et al., 2020). The patient complained of chest tightness and inability to walk up the stairs without help.

Causes/Risk Factors

There are several risk factors for CHD. Some are modifiable, while others are not. The modifiable risk factors include high blood pressure, high cholesterol levels, smoking, obesity, diabetes, physical inactivity, stress and an unhealthy diet. The non-modifiable risk factors are advanced age, sex, family history and ethnicity.

Hypertension

It is one of the risk factors in CHD development. It increases the incidence of atherosclerotic CHD. The risk burden is increased 2-3 fold (Brown et al., 2020). CHD is the most common outcome of hypertension in all ages. Hypertension predisposes patients to all CHD clinical manifestations, such as angina pectoris, myocardial infarction, and sudden death (Brown et al., 2020). Even high normal blood pressure readings are linked with increased CHD risk (Brown et al., 2020). The presence of other CHD risk factors, such as obesity, hyperlipidemia, and diabetes, is observed in more people with prehypertension than those with normal BP readings (Brown et al., 2020). Prehypertension is thus a risk for CHD.

Hypercholesterolemia

High cholesterol levels are a major risk factor for CHD. There is a strong relationship between serum cholesterol levels and cardiovascular risk. Total serum cholesterol level is a useful marker for predicting CHD. LDL-cholesterol is directly associated with CHD (Brown et al., 2020). Current guidelines note that LDL-C is the primary target for hypercholesterolemia therapy (Brown et al., 2020). HDL-C is an important factor in atherosclerosis. Raising HDL-C is an important therapeutic strategy for reducing  CHD incidence rates (Brown et al., 2020).

Smoking

Smokers have an increased risk of myocardial infarction or sudden death linked to the number of cigarettes smoked daily (Brown et al., 2020). Cigarettes have harmful effects, with epidemiological statistics proving this to be true concerning CHD. Evidence shows that smoke cessation reduces nonfatal myocardial mortality (Brown et al., 2020). Patients with heart diseases should be advised on smoke cessation strategies. The risk of mortality linked with cigarette smoking falls after smoke cessation. Approximately 20% of patients who give up smoking after acute myocardial infarctions have a 40% reduction in infarct recurrences and mortality rates (Brown et al., 2020). The risk of developing CHD for smokers below 50 years is ten times greater than for