593 Peer Response – Danielle

Peer Responses:

  • Length: A minimum of 180 words per post, not including references
  • Citations: At least two high-level scholarly reference in APA per post from within the last 5 years

The patient’s plan includes a series of essential measures designed to expedite the identification and treatment of the suspected acute heart disease. It is imperative to promptly refer the patient to the emergency room in light of the presence of symptoms indicative of cardiac distress, such as chest pain, deteriorating dyspnea and 10 lb weight gain in a week. Upon admission to the emergency room, a thorough diagnostic evaluation will commence, first with an electrocardiogram (ECG) to evaluate the presence of myocardial ischemia or infarction (Body, 2018). Furthermore, the acquisition of cardiac biomarker testing, specifically the measurement of troponin levels, will be conducted in order to assess the presence of myocardial injury, hence offering additional understanding of the degree of cardiac involvement (Body, 2018). The utilization of a chest X-ray may also be deemed appropriate in order to evaluate indications of congestive heart failure or other cardiopulmonary pathology, hence facilitating the development of a precise diagnosis (Body, 2018). The primary objective of stabilization and treatment endeavors will be to ensure sufficient oxygenation by administering supplementary oxygen to achieve optimal levels of oxygen saturation. In addition, the patient’s clinical presentation and diagnostic findings will guide the administration of suitable drugs for the purpose of alleviating chest discomfort and managing blood pressure (Body, 2018). The patient’s status will be continuously monitored, and any changes rapidly detected by continuous cardiac monitoring and vital sign assessment. Simultaneously, preparations will be made for a meeting with a cardiology specialist and admission to the hospital to allow for the additional evaluation and treatment of the suspected cardiac issue by specialized cardiac specialists. The implementation of this comprehensive approach guarantees prompt intervention and the provision of appropriate care to address the patient’s acute cardiac issues effectively and promptly.

While emergency room transportation is being arranged, additional questions to be asked:

Symptoms:

  • Can you describe the nature of your chest discomfort in more detail? Is it sharp, dull, or pressure-like?
  • Do you experience any symptoms of shortness of breath at rest or only with exertion?
  • Have you noticed any swelling in your legs or ankles, if so how long? Sudden Weight gain?
  • What other symptoms are you experiencing, such as fatigue, dizziness, or palpitations?

Medical History:

  • Do you have a history of heart disease, such as angina or heart attacks?
  • Have you been diagnosed with any other chronic conditions, such as diabetes or hypertension?
  • Have you experienced any recent changes in your health or medications?
  • Do you have any family history of heart disease or other medical conditions?

Lifestyle Factors:

  • Do you smoke cigarettes, vape or smoke cannabis, or use any other tobacco products?
  • How is your diet and level of physical activity? Do you eat fast food?
  • Have you experienced any recent stress or lifestyle changes?
  • Why did he run out of the medications? Is he having trouble paying for them?

Differential Diagnosis:

Acute Coronary Syndrome (ACS): Considering the patient’s chest pain, difficulty breathing, and increased heart rate, the presence of acute coronary syndrome (ACS), such as unstable angina or myocardial infarction, is a significant worry, particularly considering the patient’s history of deteriorating symptoms in the last week (Body, 2018).

Congestive Heart Failure (CHF): The patient’s dyspnea, increased body weight, and high blood pressure indicate a potential worsening of congestive heart failure (CHF), especially considering the existence of chest pain and reduced oxygen saturation (Marini et al., 2023).

Unregulated hypertension: The presence of increased blood pressure and feelings of chest pain in the patient may suggest the presence of unmanaged hypertension, a condition that can give rise to various problems, including hypertensive crisis or damage to certain organs (WHO, 2023).

Body, R. (2018). Acute coronary syndromes diagnosis, version 2.0: Tomorrow’s approach to diagnosing acute coronary syndromes? Turkish Journal of Emergency Medicine, 18(3), 94-99.

Marini, M., Manfredi, R., Battistoni, I., Francioni, M., Vittoria Matassini, M., Pongetti, G., Angelini, L., Shkoza, M., Bontempo, A., Belfioretti, L., & Piero Perna, G. (2023). Acute heart failure: Differential diagnosis and treatment. European Heart Journal Supplements, 25(Supplement_C), C276-C282.

WHO. (2023, March 16). Hypertension. World Health Organization.