Advanced Physiology (BIO 3413) Cardiovascular Case Histories - Case 1

Cardiovascular Case Histories – Case 1

Advanced Physiology (The University of Texas at San Antonio)

Case studies – This is a document containing the answers and questions for a lot of the case studies we go over in class
This is a document containing the answers and questions for a lot of the case studies we go over in class.
The University of Texas at San Antonio
Advanced Physiology (BIO 3413)

1. What is the underlying physiological problem for this patient?

2. What is dyspnea and why does the patient experience dyspnea while sleeping; why do the symptoms disappear after he sits up in bed?

3. What is the cause of the peripheral edema and the distending veins?

1. Based on the information provided, which A-V valve is incompetent, allowing the regurgitation?

A 56-year old man has come to the emergency room complaining of fatigue, weakness, dyspnea, and exercise-induced chest pain that radiates to his left arm and neck (angina). His history indicates that, in the past couple of years, he has had several minor episodes of angina during periods of sudden exertion. Recently, he has awakened several times at night with the feeling that he cannot breathe; however, these sensations has gone away after a few minutes of sitting upin bed. A physical examination shows a relatively low blood pressure of 110/80 mm Hg, a weak pulse, and heart rate of 100 beats per minute.

The patient has swollen ankles (edema), and the jugular veins in his neck are visibly distended. An ECG analysis indicates the electrical activation of hi heart is proceeding normally from the atria to the ventricles (normal sinus rhythm). The ECG does indicate an elevated ST segment. The physician performs and echocardiography examine of the heart and notices the patient’s heart is dilated andcontains more blood than does a normal heart. To visualize the coronary arteries, a dye which is visible on a portable X-ray screen is injected into the coronary arteries. The dye is introduced through a catherter that is inserted into a femoral artery.

The imaging of the arterial tree indicates significant narrowing of several segments of the coronary arteries. The patient was treated with bed rest, digitalis and a diuretic. After three months, the patient was admitted for coronary artery bypass surgery.

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