Mr Chena 74 year old male presents to the ED very diaphoretic, pale, and is complaining of midsternal chest pain. He states that “I feel like I am going to die!” The EKG shows
Story:
Mr Chena 74 year old male presents to the ED very diaphoretic, pale, and is complaining of midsternal chest pain. He states that “I feel like I am going to die!” The EKG shows:
1. What rhythm do you see?
a.Normal sinus rythym
b. Supraventricular tachycardia
c. Atrial fibrillation
d. Ventricular tachycardia
Story continued:
An IV was started, usual meds given to start management of MrChen’s chest pain and EKG. Labs were sent
Component/
Normal range
WBC 5.0-10.0 1000/mm3 7.7
RBC 4.0-6.0 million/mm3
HGB 12.0-16.0 gm/dL 8.4
HCT 36-46% 28
MCV 80-98 µm3 45.3
MCHC 32-36 g/dL 15.7
Platelet count 140-370 1000/mm3 180
Neut 50-70% 53
Sodium 135-145 mEq/L 137
Potassium 3.5-5 mEq/L 4.3
Chloride 95-107 mEq/L 98
Creatinine 0.5-1.2 mEq/L 1.2
Blood Urea Nitrogen 7-20 mg/dL 19
Glucose <100 mg/dL 138
Troponin <0.04 ng/mL 0.038
BNP normal range for men 61-82yrs 53-91 pg/mL and >83 yrs< 93 pg/mL
450
2. What are the abnormal labs?
3. What kind of anemia do you suspect your patient has?
MrChenwas admitted for anemia and to repeat cardiac enzymes. You make your rounds and find that MrChen has become very short of breath with a respiratory rate of 24 and that his monitor shows that is pulse ox saturation is 80%, heart rate is 130, and blood pressure is 140/98. When you auscultate his lungs, you hear crackles in the bases bilaterally.
The repeat labs come in during your assessment andshow:
Troponin <0.04 ng/mL 0.04
BNP normal range for men 61-82yrs 53-91 pg/mL and >83 yrs< 93 pg/mL
500
4.
1. What is the relationship of anemia to myocardial ischemia and heart failure?
2. What is the relationship of BNP and heart failure?
5. websites like http://nataonline.com/np/440/anemia-and-cardiovascular-disease to write this paper.
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