Mrs. Sunshine, a 54-year-old African American woman, is traveling from Denver to Boston to see her son who is studying at UMASS Boston School of Nursing to be a family nurse practitioner.

Mrs. Sunshine, a 54-year-old African American woman, is traveling from Denver to Boston to see her son who is studying at UMASS Boston School of Nursing to be a family nurse practitioner.

He has not seen his mother since he left Denver 2 years ago. He has been quite busy with a new position and a new family besides taking an advanced pathophysiology course. Anyway, at the airport, he noticed that his mother was short of breath and looked very tired and anxious. When he asked whether she had chest pain, she denied chest pain but admitted that she did have some chest discomfort at the Denver airport. He knows that his mother has hypertension and has not been faithful about taking her medications. He called 911 and took his mother to the hospital directly, despite Mrs. Sunshine’s objections. She told him that she did have dyspnea and fatigue for the past week and she thinks that she might have the flu or perhaps it’s just the long trip that made her tired and caused some breathing problems.

Relevant lab values (assume all other lab values are normal)

Laboratory tests show Na =138; K= 6.2; Cl =106; BUN =28; Cr= 2.4; Cholesterol= 248 mg/dl, LDL= 160 mg/dl.

Date
3/15
3/15
3/16
3/16

Time
1700
2400
0600
1400

CPK
778
966
598
103

CPK-MB
12
15
10
2

Troponin T: µg/l
0.03
0.5
1
1
Relevant diagnostic tests:
Chest X ray: lungs clear, tortuous aorta, cardiomegaly
ECG: inferior MI; St segment elevation, T wave elevation, pathologic Q waves.

In your review of this case, please address the following questions and please include at least 5 research articles and /or web citations as references.

What are the etiology and risk factors associated with this case?
What is the pathophysiological basis for the signs/symptoms and lab results that are seen in this case?
What are the potential complication of this case and why might they occur?
What are the usual treatment(s) and expected effects of such treatment(s) for this case?
Is there anything unusual about this case? If so, what and why?


 

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