A 70-year-old J.M. man who has been coming to the clinic forseveral years for management of coronary artery disease (CAD),hypertension (HTN), and hyperlipemia (HLD). A cardiaccatheterization done a year ago showed 50% stenosis to one of hiscoronary arteries.
For the past 6 months, he has had episodes of dizziness,orthostatic hypotension, and decreased exercise tolerance.
On his last clinic visit 3 weeks ago, a chest x-ray (CXR) showedcardiomegaly. Results of chemistries (blood studies) drawn at thistime were as follows: Na 136 mmol/L, K 4.2 mmol/L, BUN 15 mg/dl,creatinine 1.6 mg/dl, glucose 93 mg/dl, Complete Blood Count (CBC):WBC 4.4, Hgb 9.5 g/dl, Hct 29.4%, and platelets 229
This morning his son brought him to the clinic because he hashad increased fatigue, significant swelling of his ankles, andshortness of breath (SOB) for the past 2 days. His vital signs (VS)are Blood pressure (BP) of 142/83, Heart rate (HR) of 105,Respiratory rate (RR) of 24, and Temperature of 97.9° F.
After reading this case study, be ready to answer follow upquestions in the quiz section titled: Heart Failure Case StudyFollow-up Questions.
1. The Health Care Provider concluded that Mr. J.M. isexperiencing symptoms of Heart Failure (HF). What classes of drugsmight the Health Care Provider prescribe? And how might they workto help J.M.’s condition. (Hint: There are up to 4 drug classes forconsideration).
2.Explain why Mr. J.M. is experiencing increased fatigue, ankleswelling, and shortness of breath (with a respiratory rate of24).
3.Other than a history of hypertension, give one pathology whyMr. J.M.’s BP is 142/83 (elevated).
4.Use your own words to describe the correlation between HTN andHF in Mr. J.M. case study.