Discussion Post Essay

Discussion Post Essay

Discussion Post Essay

The case involves a patient with a history of occasional stabbing chest pains for about two years. The patient complains of pain that started four hours earlier and has been persistent. The pain is centrally located with some rations on both sides of the chest. Besides, he had Covid-19 symptoms that lasted for fourteen days. He also has a history of migraine and a family history of myocardial infarction, and high cholesterol levels.

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The first differential diagnosis is angina. Angina is a condition characterized by narrowing the coronary artery that results in insufficient blood supply to the heart muscles. The patient has a familial history of cardiovascular diseases, which means that he is vulnerable to the disease (Fang et al., 2019). Besides, the patient has a history of high cholesterol levels, which is associated with the development of angina pectoris. The magnitude of pain increases with the severity of the hypoxia caused by inadequate blood and oxygen supply to the heart muscles.

The second differential diagnosis is myocardial infarction which results from the blockage in the coronary arteries, thus limiting the blood supply to the heart muscles. Heart attack is characterized by severe chest pain at rest and could result in fatality if the blockage is not removed in time (Fang et al., 2019). People with a family history of myocardial infarction and hypercholesteremia are at increased risk of getting a heart attack, as evident in this case. Also, the patient smokes two 12-packs of beer per week which could also increase the risk for heart attack. The ECG results also suggest cardiovascular distress.

Thirdly, the patient could be having gastroenteritis reflux disease. A burning sensation in the chest characterizes the condition. The pain could also be radiated to the ends of the chest. The patient does not have any history of GERD; however, further assessment should be done to determine the possibility of having the disease.

Reference

Fang, J., Luncheon, C., Ayala, C., Odom, E., & Loustalot, F. (2019). Awareness of heart attack symptoms and response among adults — the United States, 2008, 2014, and 2017. MMWR. Morbidity and Mortality Weekly Report, 68(5), 101-106. https://doi.org/10.15585/mmwr.mm6805a2

please answer the questions for the patient scenario, minimum 250 words thank you

Based on the following information, create a list of three differential diagnoses and explain why you would include them on your list.

History
C.R., a 34-year-old man, came to your clinic with an episode of chest pain. He has a previous history of occasional stabbing chest pain for 2 years. The current pain had come on 4 hours earlier at 8 p.m. and has been persistent since then. It is central in position, with some radiation to both sides of the chest. It is not associated with shortness of breath or palpitations. The pain is relieved by sitting up and leaning forward. Two Tylenol tablets taken earlier at 9 p.m. did not make any difference to the pain.

The previous chest pain had been occasional, lasting a second or two at a time and with no particular precipitating factors. It has usually been on the left side of the chest although the position has varied.

Two weeks previously he had mild to moderate symptoms of COVID-19 which lasted 14 days. This consisted of a sore throat, low-grade fever, loss of taste and smell, and a cough. His wife and two children were ill at the same time with similar symptoms but have been well since then. He has a history of migraines. In the family history, his father had a myocardial infarction at the age of 51 years and was found to have a marginally high cholesterol level. His mother and two sisters, aged 36 and 38 years, are well. After his father’s infarct, he had his lipids measured; the cholesterol was 5.1 mmol/L (desirable range < 5.5 mmol/L). He is a nonsmoker who drinks two 12-packs of beer per week.

Examination
His pulse rate is 75/min, blood pressure 124/78 mmHg. His temperature is 37.8C. There is nothing abnormal to find in the cardiovascular and respiratory systems. The ECG findings include diffuse concave-upward ST-segment elevation and, occasionally, PR-segment depression.