Diagnosis of Heart Disease
A 65 year old woman with a history of hypertension, allergic rhinitis, GERD and a murmur arrived at the hospital. The patient stated that for the past four months she has noticed an increase in exertional dyspnea, orthopnea, and occasional feelings of heart pounding. The patient’s vital signs were taken and were recorded as follows: * Temperature: 98.6
* Respiratory Rate: 24 bpm
* Heart Rate: 123 bpm
* Blood Pressure: 160/40
After a physical assessment, there were some abnormalities found. There appeared to be a soft systolic murmur, course crackles in the bases of lungs, and a prominent jugular pulse. Explanation of Cardio System
Typically, the heart goes through two phases: systole and diastole, or contracting and relaxing. The blood is pumped from the right atrium into the right ventricle, then into the pulmonary artery and into the lungs. The blood then goes into the left atrium via the pulmonary vein, and into the left ventricle. Once the blood reaches the left ventricle, it is pumped to the rest of the body by the aorta. The heart normally follows a specific “pumping pattern”, in which it produces a “lub dub” sound. The first lub sound is termed S1, and the second dub sound is termed S2. S1 is heard when the AV valves close, which is at the beginning of systole. S2 is heard when the semi lunar valves close, which is at the end of systole. Sometimes after the end of S2, you will hear a third or fourth sound which are appropriately named S3 and S4. These extra sounds indicate a gallop and are not always harmful, but are not normal.
Based on the patient’s symptoms, she is showing a manifestation of heart failure. A major manifestation of left-sided heart failure is shortness of breath due to congestion of the pulmonary circulation. (Porth & Matfin, 2009) The patient’s complaint of a pounding heart maybe a sign of...