Cardiovascular Alterations

At least once a year, the media report on a seemingly healthy teenage athlete collapsing during a sports game and dying of heart complications. These incidents continue to outline the importance of physical exams and health screenings for teenagers, especially those who play sports. During these health screenings, examiners check for cardiovascular alterations such as heart murmurs because they can be a sign of an underlying heart disorder. Since many heart alterations rarely have symptoms, they are easy to miss if health professionals are not specifically looking for them. Once cardiovascular alterations are identified in patients, it is important to refer them to specialists who can further investigate the cause.

Consider the following scenario:

A 16-year-old male presents for a sports participation examination. He has no significant medical history and no family history suggestive of risk for premature cardiac death. The patient is examined while sitting slightly recumbent on the exam table and the advanced practice nurse appreciates a grade II/VI systolic murmur heard loudest at the apex of the heart. Other physical findings are within normal limits, the patient denies any cardiovascular symptoms, and a neuromuscular examination is within normal limits. He is cleared with no activity restriction. Later in the season he collapses on the field and dies.

To prepare:

Review the scenario provided, as well as Chapter 24 in the Huether and McCance text. Consider how you would diagnose and prescribe treatment for the patient.

Readings

Huether, S. E., & McCance, K. L. (2012). Understanding pathophysiology (Laureate custom ed.). St. Louis, MO: Mosby.

Chapter 22, “Structure and Function of the Cardiovascular and Lymphatic Systems”

This chapter examines the circulatory system, heart, systemic circulation, and lymphatic system to establish a foundation for normal cardiovascular function. It focuses on the structure and function of various parts of the circulatory system to illustrate normal blood flow.

Chapter 23, “Alterations of Cardiovascular Function”

This chapter presents the pathophysiology, clinical manifestations, evaluation, and treatment of various cardiovascular disorders. It focuses on diseases of the veins and arteries, disorders of the heart wall, heart disease, and shock.

Chapter 24, “Alterations of Cardiovascular Function in Children”

This chapter examines cardiovascular disorders that affect children. It distinguishes congenital heart diseases from acquired cardiovascular disorders.

McPhee, S. J., & Hammer, G. D. (2012). Pathophysiology of disease: An introduction to clinical medicine (Laureate Education, Inc., custom ed.). New York, NY: McGraw-Hill Medical.

Chapter 10, “Cardiovascular Disorders: Heart Disease”

This chapter begins by exploring the normal structure and function of the heart. It then examines the etiology, pathophysiology, and clinical manifestations of five heart disorders: arrhythmias, congestive heart failure, valvular heart disease, coronary artery disease, and pericardial disease.

Jacobsen, R. C., & Gratton, M. C. (2011). A case of unrecognized prehospital anaphylactic shock. Prehospital Emergency Care, 15(1), 61–66.

Retrieved from the Walden Library databases.

This article provides information relating to the diagnosis and management of anaphylactic shock. It also explores difficulties encountered when diagnosing uncommon clinical presentations of anaphylactic shock.

***INSTRUCTIONS FOR PAPER***

Select one of the following patient factors: genetics, ethnicity, or behavior. Reflect on how the factor you selected might impact diagnosis and prescription of treatment for the patient in the scenario.

Write a description of how you would diagnose and prescribe treatment for the patient in the scenario. Then explain how the factor you selected might impact the diagnosis and prescription of treatment for that patient.