Cardiovascular and respiratory examination

Case Study 1

Question (1)

Four most significant sign or symptoms for Lisa is presenting with:

Gasping and showing severe shortness of breath.

Coughing up sputum and streaks of blood.

Ruddy cheeks and Cyanosed lips

Irregularly irregular heart rate

Differential Diagnoses for Lisa

Lisa may be suffering from anxiety as palpitations itself is a symptom for anxiety.

Arrhythmia including atrial fibrillation, sinus or ventricular tachycardia may also be causing palpitation in Lisa.

Non-arrhythmic cardiac problems such as congestive heart failure or mitral valve prolapsed may also be causing palpitation in Lisa.

Decreased or increased action of thyroid hormone in Lisa's body may be causing palpitation.

Question (2) Lisa's underlying disease pathology and its effects on the normal functioning of cardiovascular system.

Lisa's underlying disease pathology is thyroid hormone. Thyroid hormone reduced or increased action on molecular pathways in vasculature and heart can cause relevant cardiovascular derangements. Numerous studies have concluded that hyperdynamic cardiovascular state is induced by over hyperthyroidism, which is closely associated with faster heart rate, Enhanced LV (Left Ventricular) diastolic and systolic function etc. Extensive evidence emerged from several studies has indicated that response of cardiovascular system to a persistent and minimal changes in circulating thyroid hormone levels. It is quite typical in persons like Lisa who is facing a palpitation.

Question (3) Lisa's ECG suggests atrial fibrillation. What is atrial fibrillation? Explain the further complications that can arise due to atrial fibrillation and how it can be managed.

(A fib) Atrial fibrillation is rapid and irregular heart rhythm. Arrhythmia (the irregular rhythm) is caused by abnormal electrical impulses that takes place in upper chambers of the heart that results in faster and irregular ventricle contraction (heart beat). Atrial fibrillation can results in further complications such as strokes, blood clot formation, heart failure. If not treated properly, atrial fibrillation can cause series as well as life threatening problems. Atrial fibrillation can be treated after determining the severity of signs and symptoms, the underlying causes, and the overall health of Lisa (or any other patient suffering from Atrial fibrillation).

(4) Explain Lisa's Echocardiogram results. Which are the two further investigations you would suggest for her and why?

Echocardiogram results helped us in diagnosing the severity of mitral valve prolapsed in Lisa. Since Lisa's palpitations is unexplained, results of her echocardiogram can be linked to mitral valve prolapsed, which is related to cardiac arrhythmias. I would like to suggest AHA and ACC for Lisa as these are good investigations to evaluate patients who are suffering from palpitation.

Question (5) Explain why Lisa has the following signs and symptoms:



(a) Red cheeks but cyanosed lips

lisa's cyanosed lips and ruddy cheeks are caused by meningeal inflammation.

(b) Cough produces small amount of whitish, frothy sputum with streaks of blood in it.

Lisa is suffering from Mitral Stenosis which is a heart valve disorder and causes sputum and streaks of blood in coughing.

(c) Loud first heart sound (S1) and low pitched diastolic murmur.

Liza's body was experiencing a brief turbulence of blood flow that caused the heart sound (S1) and low pitched diastolic ...