The first patient is a 39 year old male that presents to the ER with fatigue and shortness of breath. He has a heart rate of 133 bpm, 155/90 bp and a S2 associated with a harsh systolic ejection murmur. In addition he has hemoptysis and complains that his dyspnea is worse at night. He has bilateral rales and peripheral cyanosis. A chest x-ray demonstrates left ventricular hypertrophy.
A second 45 year old male patient has also arrived at the ER complaining of fatigue. Frankly, he smells like he has already had a few beers today. Amazingly, you can see a rhythmic distention of the jugular veins in time with his heart beat so it is easy to count! He also has pitting edema of his lower extremities. He too has sinus tachycardia of 130 bpm, 170/90 bp and a murmur too. But his x-rays shows right ventricular hypertrophy and hepatomegaly. His echocardiogram demonstrates tricuspid insufficiency and venous regurgitation. The doc-tor says this patient has heart failure too!
6. What diet restrictions should be given to both patients?
7. Please use complete sentences to get all points offered. Obviously, the second patient needs immediate endoscopy examine him for esophageal bleeding. But both patients are put on a diuretic and ACE inhibitor drugs. Think about the hormones listed above. Discuss what these drugs do and why these drugs are given.
The first patient is a 39 year old male that presents to the ER with fatigue and shortness of breath. He has a heart rate of 133 bpm, 155/90 bp and a S2 associated with a harsh systolic ejection murmur. In addition he has hemoptysis and complains that his dyspnea is worse at night. He has bilateral rales and peripheral cyanosis. A chest x-ray demonstrates left ventricular hypertrophy.
A second 45 year old male patient has also arrived at the ER complaining of fatigue. Frankly, he smells like he has already had a few beers today. Amazingly, you can see a rhythmic distention of the jugular veins in time with his heart beat so it is easy to count! He also has pitting edema of his lower extremities. He too has sinus tachycardia of 130 bpm, 170/90 bp and a murmur too. But his x-rays shows right ventricular hypertrophy and hepatomegaly. His echocardiogram demonstrates tricuspid insufficiency and venous regurgitation. The doc-tor says this patient has heart failure too!
6. What diet restrictions should be given to both patients?
7. Please use complete sentences to get all points offered. Obviously, the second patient needs immediate endoscopy examine him for esophageal bleeding. But both patients are put on a diuretic and ACE inhibitor drugs. Think about the hormones listed above. Discuss what these drugs do and why these drugs are given.
