Case Study 1- Thorax A 72 year old male came to emergency with a complaint of di
ID: 94273 • Letter: C
Question
Case Study 1- Thorax A 72 year old male came to emergency with a complaint of difficulty in breathing and dyspnea (feeling short of breath). You learn he has smoked since he was 18. In the past he had smoked a pack a day but due to finances has a limit of 4 cigarettes a day. He has tried to stop smoking but has been unsuccessful. During your conversation you note he has a persistent and productive (mucus producing) cough he reports he has had this cough for years. His blood pressure is 102 (normal is 60-100), and you note crackling and wheezing when auscultating (listening to sounds produced with a stethoscope) both lungs. No abnormal sounds were noted when auscultating the heart. Distention of neck veins and mild edema at the wrist and ankle were noted. Radiographic analysis demonstrates right ventricular hypertrophy (enlargement). Radiographic analysis of the lungs revealed several dark fields. EKG was unremarkable (normal). In practice questions- please keep in mind that the e denser a tissue is (think bone) the brighter/whiter the tissue appears on a radiograph.Explanation / Answer
4.
Right Ventricle Hypertrophy (RVH) is identified by development of symptoms like cardiac failure which include shortness of breath, chest pain, swelling of the lower extremities, and episodes of loss of consciousness. Since the 72 year patient has difficulty in breathing and felling shortness of breath, so it would be Right Ventricle Hypertrophy.
5.
Yes, it is, because excessive mucus (cough) production in bronchial tree causes chronic bronchitis. If any complication in chronic bronchitis cause recurrent respiratory tract infection, right ventricular hypertrophy with right- sided heart failure due to increase right ventricular end-diastolic pressure, pulmonary hypertention, heart failure, increase venous pressure, dependent edema and acute respiratory failure.
6.
The final diagnosis of RVH is electrocardiogram (ECG).
Because ECG test will determine the heart size and provide details about the function of the
heart.
7.
The diagnosis will be an electrocardiogram (EKG).
The Electrocardiogram (ECG or EKG) record the electrical signals that travel through heart and sound waves that produce give live-action images of heart. It also give the details about thickened muscle tissue in the left ventricle, blood flow through the heart with each beat, and heart abnormalities related to left ventricular hypertrophy .
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