The patient’s objective and subjective data confirm the diagnosis of coronary artery disease. Notably, a fractional flow reserve (FFR) of 0.73, S4 gallop, S3 gallop, coronary artery stenosis, chest pain (angina), shortness of breath, and lightheadedness confirm the diagnosis of coronary artery disease (Abd Samir et al., 2018). This disease results from plaque deposition in coronary arteries.
The two risk factors for the patient are dyslipidemia and hypertension. Laboratory results indicate that the patient has elevated low-density lipoproteins, elevated levels of triglycerides, and low levels of high-density lipoproteins. The average values for these lipid profiles are 100 mg/dl, 150 mg/dl, and 60 mg/dl, respectively (Clevelandclinic.org, n.d.). Elevated levels of low-density lipoproteins increase the risk of atherogenesis and coronary stenosis (Abd alamir et al., 2018). As a result, the patient’s likelihood of developing coronary artery disease increases. Low-density lipoproteins are easily oxidized and transported to the endothelium. Oxidized low-density lipoproteins prevent the endothelium’s vasodilation by inhibiting nitric oxide synthase activity (Abd alamir et al., 2018). Furthermore, oxidized low-density lipoproteins promote the accumulation of cholesterol (Abd alamir et al., 2018). These actions encourage atherogenesis and increase the risk of coronary artery disease.
The patient is a known hypertensive, increasing his risk for coronary artery disease. Hypertension triggers endothelial dysfunction (Vidal-Petiot et al., 2018). By so doing, hypertension compounds the process of atherosclerosis and increases the risk for coronary artery disease. Left ventricular hypertrophy resulting from chronic hypertension leads to myocardial ischemia (Vidal-Petiot et al., 2018). This worsens the manifestation of coronary artery disease.
Abd alamir, M., Goyfman, M., Chaus, A., Dabbous, F., Tamura, L., Sandfort, V., Brown, A., & Budoff, M. (2018). The Correlation of Dyslipidemia with the Extent of Coronary Artery Disease in the Multiethnic Study of Atherosclerosis. Journal of Lipids, 2018, 1–9. https://doi.org/10.1155/2018/5607349
Clevelandclinic.org. (n.d.). Lipid Panel. https://my.clevelandclinic.org/health/diagnostics/17176-lipid-panel
Podder, V., Lew, V., & Ghassemzadeh, S. (2021). SOAP Notes. https://www.ncbi.nlm.nih.gov/books/NBK482263/
Vidal-Petiot, E., Greenlaw, N., Ford, I., Ferrari, R., Fox, K. M., Tardif, J. C., Tendera, M., Parkhomenko, A., Bhatt, D. L., & Steg, P. G. (2018). Relationships between Components of Blood Pressure and Cardiovascular Events in Patients with Stable Coronary Artery Disease and Hypertension. Hypertension, 71(1), 168–176. https://doi.org/10.1161/HYPERTENSIONAHA.117.10204