Online Assignment; Activity 1 Essay Example

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ONLINE ASSIGNMENT

QUESTION 1:
The following could be the differential diagnosis based on the three parameters given (Papadakis and McPhee, 2015):
Angina pectoris
Acute myocardial infarction
Supraventricular tachyarrythmia
QUESTION 2:
Myocardial Infarction (MI) is a medical emergency characterized by impaired blood flow to the musculature of the heart secondary to a thromboembolic event. The events that lead to generation of the symptoms giving in the question are discussed by Huether and McCance (2013, p. 606) and restated here:
The myocardium of the heart undergoes cyanosis and cooling after 8 to 10 seconds with oxygen reserve consumption. The body initiates energy production through anaerobic means which ultimately leads to lower pH in the body and specifically in the myocardial cells. The non-existent buffering capacity of myocardial cells against low pH leads to vicious cycle of myocardial injury. The myocardium loses strength and vigour to carry out normal contractility of the heart and blood is not adequately circulated. Barrett, Brooks, Boitano and Barman (2010) states that the ischemia and hypoxia caused by the inadequate pumping of blood by the already weakened heart promotes accumulation of anaerobic metabolites in the body tissues located peripherally. This generates an overall hypoxic state in the body. Moreover, this hypoxia causes electrolyte imbalance in the cellular machinery which further exacerbates the cardiac contractility. The compensatory response stimulates the heart to contract forcefully via positive ionotropy and chronotropy. Blood pressure is raised due to forceful contractions and increased pre-load on the cardiac tissue. According to Frank-Starling law, muscles oppose the incoming quantum of force exerted on them by the influx of blood. Besides raised blood pressure, the ejection fraction of the heart in each beat is decreased which stimulates the heart to contract more rapidly which is explained by increase pulse.
Lastly, the overall acidotic state of the body and the hypoxia encourages and send signals to the lung via brain signals. These signals are sensed by chemoreceptors present in greater vessels and measure the CO2 concentrations in the blood with osmolality. The higher partial pressure of CO2 (pCO2) stimulates the pulmonary system and increases the rate of breathing. The increased breathing is called as tachypnea. This response is also generated due to decreases perfusion in the tissues and increased oxygen demand. The O2 stores of the body are depleted and stimulus is sent to initiate rapid breathing to replenish the oxygen stores and protect the tissues from ischemic and hypoxic events.

REFERENCES

Barrett, K., Brooks, H., Boitano, S., & Barman, S., 2010. Ganong’s Review of Medical Physiology (Lange Medical Books). 23rd Edition. McGraw-Hill Education
Huether, S., & McCance, K., 2013. Understanding Pathophysiology. 5th Edition. Elsevier Medical.
Papadakis, M.A., McPhee, S.J., 2015. Current Medical Diagnosis & Treatment; 2015 (Lange Medical Books). 54th Edition. McGraw-Hill Education.