Day 1
John Smith ,62 years old male body weight 160 kg and height 1745cm long term smoker. Today he is consulting his GP with his blood lipid profile which resulted LDL -5.6, HDL -0.4, TG-5.7and total cholesterol -9.4.
Q1. Ideal Total Cholesterol (TC) should be 4 mmol/L or less, LDL-Cholesterol (LDL) should be 3 mmol/L or less and HDL-Cholesterol it should be over 1mmol/L (men) overall Total Cholesterol the lower figure is the better. In Johns result he has Total Cholesterol of 9.40 which is HIGH RISK, LDL of 5.6 is VERY HIGH RISK, HDL of 0.4 is HIGH RISK and Triglyceride level of 5.7 is VERY HIGH RISK of developing a heart disease.
Q2. Chances of developing atherosclerosis in john smith condition increase with the number of risk factors these include high in total Cholesterol and LDL in the blood, low level of HDL in the blood. His blood pressure 150/90 moderately high, being a tobacco smoker for many years and obesity (160 kg) specially weight gain after his retirement and lack of physical activity may mainly contributing him to developing atherosclerosis. Also increasing age can alter the endothelial layer of the blood vessels can leads to risk of developing atherosclerosis. Furthermore, gender could influence the risk of developing atherosclerosis where females has low risk of developing atherosclerosis due to sex hormones contribution but men has high risk of developing atherosclerosis. Q3. The development of atherosclerosis occurs in multiple process. Firstly, it begins with endothelial cell injury which allows the LDL to enter the sub endothelium due to smoking, obesity, uncontrolled hypertension and high level of LDL. This process allows macrophages to enter the sub endothelium and LDL in the sub endothelium is engulfed by macrophages which forms a fatty streak cells in blood vessels. As result macrophages releases growth factors which increase the smooth muscle growth and increase the deposition of collagens. An accumulation of these plaque enhances some inflammatory responses in blood vessels which consequently leads to fibrous / hard or soft and complicated plaque in the blood vessels could end up with impaired vasodilatation and thrombosis. Q4. Atherosclerosis can occur in arteries anywhere in the body. John may be developing his atherosclerosis in coronary arteries because he has symptoms such as Chest pain, shortness of breathing and poor blood circulation are primary stage symptoms of atherosclerosis in coronary arteries. Coronary atherosclerosis could cause serious medical condition such as angina, myocardial infarction (MI), ischemic stroke, thrombosis, as well as death. Therefore, this location should be closely observed by stress testing, capillary refill based on colour and temperature regarding touch. Day 2 Restless and disturbed night for john smith today morning he became anxious about is blood result and had a chest pain nearly 28 minutes when paramedic arrived his blood pressure(BP) 175/95, heart rate(HR) at 125 and respiratory rate(RR) was 28 breath /min. his pain has stopped after the administering glyceryl trinitrate(GTN) and Aspirin. Arrival on hospital his ECG revels …show more content…
One of the potential reasons for the excess risk of myocardial infarction(MI) or angina is associated with stress. In john’s condition is that stress triggers the sympathetic never systems by releasing hormones such as adrenaline and noradrenaline. Increased sympathetic activity leading to increased blood pressure levels and pulse rates. Also reduced insulin sensitivity or intolerance to glucose and increased blood clotting and blood vessel dysfunction. Reduced blood flow to the heart which resulted with increased respiratory rate. John experience above all response due to his stress since his total cholesterol level revels that he is in high risk in developing atherosclerosis in the arteries. Evidences show that continue to experience stress could leads to heart attack or …show more content…
Glyceryl trinitrate (GTN) is one the most effective drugs for providing rapid symptomatic relief of angina. One of the reason of having chest pain is that the heart is not receiving sufficient amount of oxygen results from atherosclerotic plaques in coronary arteries. Hence, administering glyceryl trinitrate (GTN) to john has allowed potent vasodilation of coronary arteries to increase the blood flow. Their principle benefit follows from a reduction in venous return which reduces the left ventricular work. Aspirin as an antiplatelet drug decrease platelet aggregation and may inhibit further thrombus formation in arterial circulation, including the coronary vessels. Administration of aspirin will prevent John from recurrent
John Smith ,62 years old male body weight 160 kg and height 1745cm long term smoker. Today he is consulting his GP with his blood lipid profile which resulted LDL -5.6, HDL -0.4, TG-5.7and total cholesterol -9.4.
Q1. Ideal Total Cholesterol (TC) should be 4 mmol/L or less, LDL-Cholesterol (LDL) should be 3 mmol/L or less and HDL-Cholesterol it should be over 1mmol/L (men) overall Total Cholesterol the lower figure is the better. In Johns result he has Total Cholesterol of 9.40 which is HIGH RISK, LDL of 5.6 is VERY HIGH RISK, HDL of 0.4 is HIGH RISK and Triglyceride level of 5.7 is VERY HIGH RISK of developing a heart disease.
Q2. Chances of developing atherosclerosis in john smith condition increase with the number of risk factors these include high in total Cholesterol and LDL in the blood, low level of HDL in the blood. His blood pressure 150/90 moderately high, being a tobacco smoker for many years and obesity (160 kg) specially weight gain after his retirement and lack of physical activity may mainly contributing him to developing atherosclerosis. Also increasing age can alter the endothelial layer of the blood vessels can leads to risk of developing atherosclerosis. Furthermore, gender could influence the risk of developing atherosclerosis where females has low risk of developing atherosclerosis due to sex hormones contribution but men has high risk of developing atherosclerosis. Q3. The development of atherosclerosis occurs in multiple process. Firstly, it begins with endothelial cell injury which allows the LDL to enter the sub endothelium due to smoking, obesity, uncontrolled hypertension and high level of LDL. This process allows macrophages to enter the sub endothelium and LDL in the sub endothelium is engulfed by macrophages which forms a fatty streak cells in blood vessels. As result macrophages releases growth factors which increase the smooth muscle growth and increase the deposition of collagens. An accumulation of these plaque enhances some inflammatory responses in blood vessels which consequently leads to fibrous / hard or soft and complicated plaque in the blood vessels could end up with impaired vasodilatation and thrombosis. Q4. Atherosclerosis can occur in arteries anywhere in the body. John may be developing his atherosclerosis in coronary arteries because he has symptoms such as Chest pain, shortness of breathing and poor blood circulation are primary stage symptoms of atherosclerosis in coronary arteries. Coronary atherosclerosis could cause serious medical condition such as angina, myocardial infarction (MI), ischemic stroke, thrombosis, as well as death. Therefore, this location should be closely observed by stress testing, capillary refill based on colour and temperature regarding touch. Day 2 Restless and disturbed night for john smith today morning he became anxious about is blood result and had a chest pain nearly 28 minutes when paramedic arrived his blood pressure(BP) 175/95, heart rate(HR) at 125 and respiratory rate(RR) was 28 breath /min. his pain has stopped after the administering glyceryl trinitrate(GTN) and Aspirin. Arrival on hospital his ECG revels …show more content…
One of the potential reasons for the excess risk of myocardial infarction(MI) or angina is associated with stress. In john’s condition is that stress triggers the sympathetic never systems by releasing hormones such as adrenaline and noradrenaline. Increased sympathetic activity leading to increased blood pressure levels and pulse rates. Also reduced insulin sensitivity or intolerance to glucose and increased blood clotting and blood vessel dysfunction. Reduced blood flow to the heart which resulted with increased respiratory rate. John experience above all response due to his stress since his total cholesterol level revels that he is in high risk in developing atherosclerosis in the arteries. Evidences show that continue to experience stress could leads to heart attack or …show more content…
Glyceryl trinitrate (GTN) is one the most effective drugs for providing rapid symptomatic relief of angina. One of the reason of having chest pain is that the heart is not receiving sufficient amount of oxygen results from atherosclerotic plaques in coronary arteries. Hence, administering glyceryl trinitrate (GTN) to john has allowed potent vasodilation of coronary arteries to increase the blood flow. Their principle benefit follows from a reduction in venous return which reduces the left ventricular work. Aspirin as an antiplatelet drug decrease platelet aggregation and may inhibit further thrombus formation in arterial circulation, including the coronary vessels. Administration of aspirin will prevent John from recurrent