Case Study 5, Chapter 27, Disorders of Cardiac Function, and Heart Failure and Circulatory Shock Norris, T. (2019). Porth’s Pathophysiology: Concepts of Altered Health States. 10th Ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins. ISBN: 978-1-4963-7755-5
Martha had just finished dinner with her husband, and they had just sat down to watch television. She is 72 years old and has had a history of angina. Shortly after they sat down, Martha said she had indigestion and went to take some antacid tablets. An hour later, she began to feel warm, restless, and anxious. Her husband noticed she was looking pale and said he would take her to a nearby walk-in clinic. By the time they arrived, Martha said her left arm and shoulder were sore. Suspecting Martha was having a heart attack, her husband turned the car around and rushed her to the hospital. Three hours after the onset of her symptoms, Martha was receiving oxygen, fibrinolytic therapy, and nitroglycerin in the emergency ward. Afterward, she was moved to the cardiac unit for STEMI.
1. An ECG of Martha’s heart demonstrated an elevated ST segment. What are the physiologic effects of myocardial ischemia that produce this finding? What variables affect the ECG tracing of a patient with ACS?
2. What are the benefits of administering fibrinolytic therapy, nitroglycerin, and oxygen in the early management of STEMI?
3. What is the inflammatory response in the postinfarction recovery period? Why will Martha’s heart function be compromised after her STEMI?
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Case Study, Chapter 4, Genetic Control of Cell Function and Inheritance Marsha and Clement are both carriers of sickle cell anemia, a disease that is autosomal recessive. Their first child, Amelia, does not have the disease. Marsha and Clement are planning another pregnancy, but they are concerned about their second child having the condition. Clement’s father died from complications of sickle cell disease shortly before Amelia was born
1. What is the likelihood of Marsha and Clement having a baby with sickle cell anemia? What is the chance the baby will be a carrier of the disease, just like the parents?
The gene is recessive, so the parents will have a 25% chance of giving birth to a child with the disease. There is a 50% chance that the baby will be a carrier
2. Marsha suggested to the nurse at the local family planning clinic that if the baby were a boy, he might have a higher risk of developing the disease, just like his grandfather. How would you respond?
The disease is autosomal in nature, meaning the disease arises from an abnormality on chromosomes 1 to 22. These chromosomes are alike in both males and females.
2. When Amelia, who does not have sickle cell anemia, grows up and marries someone who does have the disease, how likely will her children have the disease?
If Amelia has children to a father with sickle cell disease, the children will be carriers only.