Chronic Illness: Coronary Heart Disease
Outline of Coronary Heart Disease
The Coronary Heart Disease (CHD) has been on the increase of late across the globe and this disease, alongside stroke have been the top causes of death in many countries like Australia (Baker Heart and Diabetes Institute, 2017). There have been cases of people succumbing to complications occasioned by the CHD hence the need for any medic or clinician to fully furnish themselves with the CHD and the causes and effects as well as how it can be managed.
CHD is a disuse characterized by the development of a waxy substance called plaque building up in the inner walls of the coronary arteries. These are the arteries responsible for supplying oxygen-rich blood to the heart muscles. The buildup of plaque on the inner walls of the arteries results into atherosclerosis and this takes many years to pile up to harmful quantities. Over the years of continued buildup, the plaque can harden or rupture/break up. The hardened plaque narrows the coronary arteries and reduces significantly the amount of oxygen-rich blood that goes through the heart. In the event that the plaque raptures or breaks up, then there can be blood clot forming around it. The consequence of a large blood clot can be a partially or completely blocked blood flow through the artery. The raptures plaques can also harden again, consequently narrowing the coronary artery (American Heart Association, 2014).
In the event that the flow of oxygenated blood to the heart muscle is significantly reduced heart attack or angina can result. Angina is defined as some sharp chest pain or discomfort which may manifest in the form of squeezing or pressure in the chest cavity. The pain can be experienced in the shoulders, neck, back, arms and the jaws. The angina pain may even manifest in a manner feeling like indigestion (Cleveland Clinic, 2017).
On the other hand, heart attack will occur in the incident that the flow of highly oxygenated blood is blocked from a section of the heart muscles. In such a case, there is need for the flow of blood to be restored as fast as is practicable, if this is not done, then the heart muscles start to atrophy. In the event of delayed treatment, then the heart attack can escalate to more serious health complications or even death (Mayo Clinic, 2017).
Over a long period of time or even years, the heart muscles can be weakened by the CHD and as a consequence lead to arrhythmias and heart failure. Heart failure is experienced when the heart cannot pump sufficient to the body to meet the demand of the body for normal functioning. Arrhythmia is a complication resulting from the rhythm or the rate of the heartbeat.
It is also worth noting that the clot can block the blood vessels to the brain, then there can be ischemic stroke experienced by the patient. In the event that a vessel within the brain bursts due to increased or high blood pressure or what is referred to as uncontrolled hypertension, then hemorrhagic stroke may be experienced.
There are some risk factors that are linked to CHD such as smoking, the male gender, diabetes, high blood cholesterol, high blood pressure, physical inactivity, excess weight, unhealthy eating, increasing age, high resting heart rate, kidney disease, depression and stress, family history of heart disease (Southern Cross, 2017).
CHD is diagnosed by first knowing the symptoms, risk factors and the medical history. The doctor can make physical examination, then run diagnostics including electrocardiogram, echocardiogram, electron beam CT scan, exercise stress test, cardiac catheterization among other tests. These are the tests that will enable the doctor to how far the heart disease has gone hence determine the best treatment for each individual case (WebMd, 2017).
There are several ways through which CHD can be managed, these include change in lifestyle for instance stopping smoking, avoiding processed food, low fat foods, low salt as well as low sugar diet. The medications used in managing CHD include aspirin and statin. There are cases where surgery procedures may be included like the coronary artery bypass procedure, stent replacement and balloon angioplasty. These however will only improve the blood flow into the heart but will not cure the CHD and the individual will need to lower the chances of having heart disease (U.S. Department of Health and Human services, 2017).
Summary/Outcome from the Interview with Maria Farmer
The patient referred himself to the nursing home and was diagnosed with CHD and was recorded to have had left hip replacement and breast cancer. She as noted to be residing mostly in a nursing home. She understands English and has a daughter as the next of kin. Her memory was noted to be intact since she had good time orientation and place recognition. The patient has no previous history of alcohol and drug use. She uses hearing aid on the left side and was noted to be walking with the aid of a stick. Her nutrition was normal and the elimination was also normal. She was not seen to be in any form of pain and had no known allergies. The last time she was hospitalized was three years before the encounter for the left hip surgery.
On her medical history, it was noticed that she has a dry skin and the coronary heart disease. The family history is noted to have had people with heart related problems. The husband suffered a heart attack, the father died of stroke, mother died of brain hemorrhage and the brother was also noted to have died from stroke.
Comparison of the impact of the chronic illness on the “patient” compared to literature
The outcome from the patient interview meshes in with the available literature on CHD. The family history is characterized by incidences full of signs of CHD like stroke of the family members and the brain hemorrhage that killed the mother which could have been due to blockage by a broken up plaque. The patient was also seen to be walking with the aid of a stick due to possible heaviness which is a major sign of CHD.
Three patent problems
There main problems presented by the patient was the CHD, the numbness causing walking difficulty and characteristic dry skin.
Self review and personal experience
This particular experienced did not only send me back to the revision of my notes on the CHD and the related complications, but also presented a true and actual case scenario of the family historical characteristics ad genetically instigated exposure to CHD. The Nursing and Midwifery Board of Australia, Registered Nurse standards for practice, places specific emphasis on the comprehensive care provision to the elderly. This involves not only handling the isolated problem the patient presents in the clinic, but also widening the enquiry to find out more historical facts that may shape the medical history of the patient.
How experience will inform therapeutic relationship
What I have learned in the process of this interview and literature study is that the historical background of any patient is very important in the treatment and management of each individual patient. The reason as to this new stand is that from the history of the patient, I was able to establish that the CHD she suffered was genetic in nature, the kin had the same complication. The future of my medical practice will involve significantly improved relationship with the family of the patient in order to find out other underlying factors that may contribute to the medical condition of the patient. I will also work closely with the medical team handling a given client since it would be important to capture in totality the medical facts of any patient before commencing any medication and management procedure.
Baker Heart and Diabetes Institute, (2017). Heart disease and stroke are the top two causes of death — and among the leading causes of disability — in Australia. Retrieved April 9, 2017 from https://baker.edu.au/health-hub/fact-sheets/cardiovascular-disease?gclid=Cj0KEQjwt6fHBRDtm9O8xPPHq4gBEiQAdxotvNmN_YV05am6ts6wLgbbEPubE3I2Z6wwGSNl0AaycX0aAnFy8P8HAQ
Cleveland Clinic, (2017). Coronary Artery Disease Symptoms. Retrieved April 9, 2017 from https://my.clevelandclinic.org/health/articles/cad-symptoms
Mayo Clinic, (2017). Coronary Heart Disease: Symptoms and Causes. Retrieved April 9, 2017 from http://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/symptoms-causes/dxc-20165314
Southern Cross, (2017). Coronary heart disease – causes, symptoms, prevention. Retrieved April 9, 2017 from https://www.southerncross.co.nz/group/medical-library/coronary-heart-disease-causes-symptoms-prevention
U.S. Department of Health and Human services, (2017). How Is Coronary Heart Disease Treated? Retrieved April 9, 2017 from https://www.nhlbi.nih.gov/health/health-topics/topics/cad/treatment
WebMd, (2017). Coronary Artery Disease. Retrieved April 9, 2017 from http://www.webmd.com/heart-disease/guide/heart-disease-coronary-artery-disease#1
American Heart Association, (2014). Atherosclerosis. Retrieved April 10, 2017 from http://www.heart.org/HEARTORG/Conditions/Cholesterol/WhyCholesterolMatters/Atherosclerosis_UCM_305564_Article.jsp#.WOx5O7glHcs
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