Diagnosis and Prescription of Treatment for the Cardiovascular Alterations
At least once a year, the media report on a seemingly healthy teenage athlete collapsing during a sports game and dying of heart complications. These incidents continue to outline the importance of physical exams and health screenings for teenagers, especially those who play sports. During these health screenings, examiners check for cardiovascular alterations such as heart murmurs because they can be a sign of an underlying heart disorder. Since many heart alterations rarely have symptoms, they are easy to miss if health professionals are not specifically looking for them. Once cardiovascular alterations are identified in patients, it is important to refer them to specialists who can further investigate the cause.
Consider the following scenario:
A 16-year-old male presents for a sports participation examination. He has no significant medical history and no family history suggestive of risk for premature cardiac death. The patient is examined while sitting slightly recumbent on the exam table and the advanced practice nurse appreciates a grade II/VI systolic murmur heard loudest at the apex of the heart. Other physical findings are within normal limits, the patient denies any cardiovascular symptoms, and a neuromuscular examination is within normal limits. He is cleared with no activity restriction. Later in the season he collapses on the field and dies.
To Prepare
· Review the scenario provided, as well as Chapter 25 in the Huether and McCance text. Consider how you would diagnose and prescribe treatment for the patient.
· Select one of the following patient factors: genetics, ethnicity, or behavior. Reflect on how the factor you selected might impact the diagnosis and prescription of treatment for the patient in the scenario.
· Assignment
- Post a description of how you would diagnose and prescribe treatment for the patient in the scenario.
- Then explain how the factor you selected might impact the diagnosis and prescription of treatment for that patient.
Cardiovascular Alterations
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Cardiovascular Alterations
Diagnosis and Prescription of Treatment for the Cardiovascular Alterations
“Dietary fat, whether saturated or not, is not a cause of obesity, heart disease or any other chronic disease of civilization.” Dr. Joanne Murabito. Cardiovascular alteration is the change in the regular performance of the heart and the blood vessels leading to numerous health conditions (Tarumi & Zhang, 2018). The alteration can stretch from lenient to extreme, affecting people of all ages. Various types of cardiovascular alteration include heart failure, coronary artery, hypertension, and arrhythmias, and they can be generated by agents like genetic predisposition, underlying health condition, and lifestyle choices. During the treatment of cardiovascular alteration, various methods are applied, including a combination of medications and modifying lifestyle, but for extreme cases, surgery is recommended (Carneiro & Zanella, 2018). Unmasking and managing the alterations on time is essential for minimizing complications, hence improving the quality of life for affected individuals. This essay will explore a case study of a 16-year-old male present for sports participation examination and describe the diagnosis and prescription for the patient, explaining the impacts of genetics on the diagnosis and prescription of treatment for the patient.
Diagnosing and Prescribing Treatment for the Patient
From the patient’s history and physical examination, the grade II/Vi systolic murmur heard loudest at the apex of the heart indicates the probability of an underlying cardiovascular condition. An additional diagnostic test is pledged, including an electrocardiogram and an echocardiogram, necessary for evaluating any structural or electrical malformation of the heart (Finocchiaro et al., 2020). From the results of the test, additional cardiac testing like stress tests and cardiac catheterization may be designated. From the case scenario, it is clear that the patient collapsed having subsequent death, urgent evaluation and treatment should begin. Cardiopulmonary resuscitation and defibrillation would be appropriate for the patient with unexpected cardiac arrest, and newfangled life support measures are also appropriate, including intravenous medications and airway management (Kim et al., 2019). The underlying cause of cardiac arrest determines the necessity for further management and treatment, including medication, lifestyle modifications, and surgical interventions. Rapid and extensive evaluation, diagnosis, and treatment of prospective underlying cardiac ambiance is vital for the prevention of sudden cardiac events in young athletes. A meticulous pre-participation examination involving a circumstantial history of cardiovascular and physical examination can be helpful for identifying individuals at maximized risk for sudden cardiac events preventing calamitous results like the one in the scenario.
The Impact of Genetics on the Diagnosis and Prescription of Treatment for the Patient in the Case Scenario
From the above case scenario, the patient’s family history was described as having no risks for premature cardiac death. Genetics execute a notable role in the diagnosis and treatment of cardiovascular conditions. Inherited genetic alteration increases the risk of an individual getting cardiac diseases, including cardiomyopathies, arrhythmias, and unexpected cardiac death (Scrocco et al., 2021). A comprehensive evaluation of the patient’s family history, including any cardiac-related death, should have been promised. From the case scenario, the patient presented a murmur during the sport participation examination, which should give rise to more evaluation of cardiac involving electrocardiogram and echocardiogram. In addition, a genetic test may also be essential in some cases to identify any underlying genetic alteration contributing to the cardiac condition, and identification of a genetic alteration can impact the prescription of treatment for the patient. Some genetic alterations can be managed through medication and modification of lifestyle, reducing the risk of unexpected cardiac death, and to an extent, a genetic test would be appropriate for the family members to ascertain individuals at risk for cardiac disease providing necessary screening and treatment (Al-Khatib et al., 2018). Genetics can also execute an essential role in diagnosing and treating cardiac alterations, where a comprehensive evaluation of family history and possibly genetic testing may be promising for the patient in the above case scenario, preventing calamitous results like cardiac death.
Conclusion
Cardiovascular alteration is the change in the regular performance of the heart and the blood vessels leading to numerous health conditions, extending from permissive to extreme, affecting people of all ages. In cases of unexpected cardiac death, a comprehensive interrogation should be conducted to distinguish the cause and the contributing factors, where factors like genetics can significantly impact the diagnosis and prescription of treatment for the patient and should be considered to make a perfect diagnosis and prescribe effective treatment. A multidisciplinary approach involving medical professionals, patients, and their family members can help minimize the risk of cardiovascular complications hence promoting better results.
References
Al-Khatib, S. M., Stevenson, W. G., Ackerman, M. J., Bryant, W. J., Callans, D. J., Curtis, A. B., … & Page, R. L. (2018). 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Journal of the American College of Cardiology, 72(14), e91-e220.
Carneiro, G., & Zanella, M. T. (2018). Obesity metabolic and hormonal disorders associated with obstructive sleep apnea and their impact on the risk of cardiovascular events. Metabolism, 84, 76-84. https://doi.org/10.1016/j.metabol.2018.03.008
Finocchiaro, G., Sheikh, N., Biagini, E., Papadakis, M., Sinagra, G., Pelliccia, A., … & Olivotto, I. (2020). The electrocardiogram in the diagnosis and management of patients with hypertrophic cardiomyopathy. Heart Rhythm, 17(1), 142-151. https://doi.org/10.1016/j.hrthm.2019.07.019
Kim, C., Choi, H. J., Moon, H., Kim, G., Lee, C., Cho, J. S., … & Jeong, W. (2019). Prehospital advanced cardiac life support by EMT with a smartphone-based direct medical control for nursing home cardiac arrest. The American Journal of emergency medicine, 37(4), 585-589. https://doi.org/10.1016/j.ajem.2018.06.031
Scrocco, C., Bezzina, C. R., Ackerman, M. J., & Behr, E. R. (2021). Genetics and genomics of arrhythmic risk: current and future strategies to prevent sudden cardiac death. Nature Reviews Cardiology, 18(11), 774-784. https://doi.org/10.1038/s41569-021-00555-y
Tarumi, T., & Zhang, R. (2018). Cerebral blood flow in normal aging adults: cardiovascular determinants, clinical implications, and aerobic fitness. Journal of Neurochemistry, 144(5), 595-608. https://doi.org/10.1111/jnc.14234
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