Chapter 12: Cardiovascular System Disorders
Case Study 1
Mr. K. is a 57-year-old man who consulted his physician after noticing marked leg pains while playing golf. He had previously noticed increasing fatigue and discomfort in his legs associated with moderate exercise. When sitting for extended periods with legs dangling, his legs became red, and sometimes his feet felt numb. His history indicates he smokes cigarettes and is chronically overweight. His blood cholesterol and other lipid levels are abnormal, and his physician suspects peripheral atherosclerosis as the cause of his discomfort.
Discuss the development of atherosclerosis, including the predisposing factors in this case and the pathophysiological changes. (See Atherosclerosis.)
Discuss the complications that might develop in this patient. (See Atherosclerosis—Pathophysiology, Signs and Symptoms.)
Discuss the treatments for all aspects of the patient’s condition, including slowing the progress of the atherosclerosis, maintaining circulation in the leg, and treating complications. (See Atherosclerosis—Treatment.)
Case Study 2
Ms. L, a 19-year-old woman with no previous medical history, was involved in a serious automobile accident in which her best friend died. Examination by EMT personnel first on the scene revealed she had only minor scrapes and bruises and no sign of head trauma. While en route by ambulance to the hospital, Ms. L complained of thirst and appeared restless. Further examination indicated a rapid pulse and respirations, with her blood pressure now at 100/60 mm Hg. She appeared less responsive to the paramedics. She was slipping into circulatory shock as they checked her again for internal injuries.
Discuss the contributing factors to shock in this case and the pathophysiologic changes causing the changes in vital signs. (See Shock—Neurogenic.)
Discuss the signs and symptoms of shock, including the rationale for each, as seen in the early stage, and as compensation mechanisms respond. (See Shock—Etiology.)
Discuss emergency and follow-up treatment for shock and for complications that may arise if not treated quickly. (See Shock—Treatment.)
Compare the types of shock, giving a specific cause, classification, and any significant changes in onset or manifestations.