23 Jul WHAT IS THE RESULT OF A LOW CARDIAC OUTPUT ON CIRCULATION?
Your patient is a 56-year-old office manager who is significantly overweight. His diet Show more Case Study 2 Your patient is a 56-year-old office manager who is significantly overweight. His diet consists of fatty foods that included red meats and high-calorie desserts. He had occasional chest pains that were relieved by nitroglycerin. One night he went to bed early because he wasnt feeling well. He awakened at 4:00 A.M. with crushing pressure in his chest and pain radiating down his left arm that was not relieved by nitroglycerin. He was nauseated and sweating profusely. He also had dyspnea especially when he was in the recumbent position. His wife stated his breathing was noisy. He called 911. The paramedics arrived and transported him to the nearest hospital. In the emergency department his blood pressure was 105/80. Inspiratory rales were present consistent with pulmonary edema and his skin was cold and clammy. Successive electrocardiograms and lab results of cardiac enzymes (creatine phosphokinase and lactate dehydrogenase) suggested a left ventricular wall myocardial infarction. His heart rate was variable during the sequential ECGs. His heart rate was 116 bpm during the first recording and 80 during the last recording. During cardiac catheterization pulmonary capillary wedge pressure was 32 mm Hg (normal 5 mm Hg). His ejection fraction measured was 0.35 (normal 0.55). His stroke volume was measured at 38 mL (normal range is 50-80 mL). 4. Assuming that the patients decreased stroke volume was consistent from the first ECG measurement until the cardiac catheterization what were his cardiac output measurements during the ECG readings? 5. The normal range for cardiac output is between 4.0 8.0 L/min. Were his measurements within normal range? What is the result of a low cardiac output on circulation? 6. Using the blood pressure measured in the emergency department what is his mean arterial pressure and pulse pressure. 7. Why is mean arterial pressure not the simple average of systolic and diastolic pressures? Show less
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