HEART SURGERIES

HEART SURGERIES

Patient: John Doe
Age: 47
Height: 6’0”
Weight: 257 lbs.

History: Mr. Doe has been a smoker for 27 years. He is a lawyer and has recently taken on a high profile case which comes with an increased amount of pressure. This has led to an increase in working hours and a strain on his 18 year marriage. His wife recently filed for divorce after being separated for a year. These events have encouraged the consumption of fast-food for nourishment during his long work hours and separation. He is frequently experiencing anxiety and shortness of breath. He has been in the hospital 6 times in the last 3 months due to fainting and chest pain (angina).

Family History: His grandfather and mother had diabetes and hypertension.

Tests: Physical examination illustrated his hypertension. The EKG test had abnormal results which indicated an underlying disease. Then we did an electron-beam computed tomography (EBCT) to look for the calcium in the lining of the arteries which was severe. The Angiocardiography (test using x-rays and dyes to produce images of the heart’s chambers and blood vessels) determined the extent and location of coronary artery disease.

Angiocardiography of Mr. Doe with several areas of disease.

http://www.smm.org/heart/videos/top.html#replacement

Diagnosis: Mr. Doe has coronary heart disease, which is the result of a sow buildup of plaque inside the heart’s arteries, and hypertension.

Treatment: Due to the extent of the disease, Mr. Doe has the option of stents or bypass surgery. Stents (simplest way to treat a heart attack is to open up the blocked artery using stents, which are permanent, tiny, metal, mesh tubes, to hold it open and improve blood flow) or bypass surgery (a piece of healthy artery or vein can be taken from other parts of the body, one end is attached to the aorta and the other end is grafted [process of joining one thing to another] to the diseased artery just below where it narrows). It he refuses to get treatment and continues to live the way he is currently living, he has a very high risk of heart attack and will eventually need a heart transplant. Also, he was strongly encouraged  reduce the amount of sodium (salt) he eats, quit smoking, get regular exercise and maintain a healthy weight, and eat a healthy diet. He was prescribed ACE inhibitors to lower blood pressure and nitrates to stop chest pain and improve blood supply to the heart.