Sison, Jenny Rose G.

January 8, 2020

BSN – IV

CASE ANALYSIS

CARDIOVASCULAR DISEASE

I. INTRODUCTION

DEFINITION

 Is a general term for conditions affecting the heart or blood vessels. It's usually associated
with a build-up of fatty deposits inside the arteries (atherosclerosis) and an increased risk
of blood clots.

RISK FACTORS

 Obesity
 Tobacco smoking
 Excess alcohol intake
 Hypertension
 Atherosclerosis (High LDL and Low HDL cholesterol levels)
 Diet
 Lack of exercise
 Family history
 Age
 Diabetes
 Ethnicity (African)
 Socioeconomic status
INCIDENCE REPORT

 2016 PSA Cardiovascular Disease is the third most leading cause of death among both
sexes in the Philippines which fall under 9.8% behind Ischaemic heart disease, neoplasms
and pneumonia)
 2016 WHO Cardiovascular Disease is the most leading cause of death among Filipinos
in both sexes with the percentile of 35%.

II. CLINICAL MANIFESTATION

 Shortness of breath
 Sweating
 Weakness
 Dizziness
 Nausea
 Rapid heartbeat
 Palpitations — the feeling that your heart is pounding hard and rapidly and is fluttering or
skipping beats

The following symptoms can be signs of either angina or the onset of a heart attack caused by
underlying CAD:

 pain, discomfort, pressure, tightness, numbness, or burning sensation in your chest, arms,
shoulders, back, upper abdomen, or jaw
 dizziness
 weakness or fatigue
 nausea or vomiting
 indigestion or heartburn
 sweating or clammy skin
 fast heart rate or irregular heart rhythm
 anxiety or a general feeling of being unwell
III. LABORATORY AND DIAGNOSTIC TEST

 Blood test – LDL, HDL, Triglycerides

 Blood sugar and Glycosylated hemoglobin is measured for detection of diabete
 Blood test - Cardiac Troponin-T, fibrinogen and PAI-1, high levels of homocysteine,
elevated asymmetric dimethylarginine and elevated brain natriuretic peptide (also known
as B-type) (BNP)
 Electrocardiogram (ECG)
 Erythrocyte Sedimentation Rate (ESR) – elevated
 C Reactive Protein – Apolipoprotein A1 and B are used to detect inflammation that may
lead to heart diseases.
 Stress Testing - The test detects the effects of the exercise on the heart.
 Echocardiography - This provides information on the shape, size, workings, valves and
chambers of the heart. Echocardiography may also be combined with Doppler to show the
areas of poor blood supply to the heart. It shows the areas of the heart muscle that are not
contracting normally, and previous injury to the heart muscle.
 Electron-Beam Computed Tomography or EBCT – helps to detect the calcium deposits or
calcifications in the walls of the coronary arteries. These are early markers of
atherosclerosis and coronary heart disease. This is not a routine test in coronary heart
disease.

IV. NURSING MANAGEMENT

1. Nurses should reinforce the importance of adopting a healthy lifestyle, even if all screening
results are negative and low risk.
2. Encourage physical activity and exercise as appropriate. Refer to local exercise
programmes, safety permitting.
3. If a patient has been prescribed medication for any of the following – hypertension,
hyperlipidaemia, angina, atrial fibrillation (AF) and diabetes – discuss the importance of
compliance because it reduces the risk of having an MI or a stroke.
V. MEDICAL / SURGICAL MANAGEMENT

 Coronary Angiography – A dye is injected into the veins to reach the coronary arteries.
This is done via coronary catheterization. Thereafter detailed pictures of the blood vessels
of the heart are taken using special imaging methods. This is called coronary angiography.
 Cardiac catheterization – involves threading of a thin, flexible tube called a catheter via a
blood vessels in the arm, groin (upper thigh), or neck. The tube is inserted under imaging
guidance till it reaches the heart. Coronary angiography detects blockages in the large
coronary arteries.

VI. PHARMACOLOGICAL MANAGEMENT

 H2 receptor blockers (drugs that also block acid production)

 Stopping use of all NSAIDs
 Follow-up endoscopy
 Probiotics (useful bacteria that may have a role in killing off H. pylori)
 Bismuth supplement
 Aspirin
 Nitroglycerine
 Oxygen
 Morphine
VII. REFERENCES (APA STYLE)

Bersales, L.G (2018, February 12) Deaths in the Philippines, 2016 Retrieved from:
https://psa.gov.ph/content/deaths-philippines-2016

Hobson, P. (2017, August 19) Cardiovascular risk factors and their management in primary care
Retrieved from: https://www.nursinginpractice.com/cardiovascular-risk-factors-and-their-
management-primary-care

WHO (2018) PHILIPPINES RISK OF PREMATURE DEATH DUE TO NCDS (%) Retrieved
from: https://www.who.int/nmh/countries/phl_en.pdf

Mandal, A. (2019, May 31) Cardiovascular Disease Diagnosis Retrieved from:

https://www.news-medical.net/health/Cardiovascular-Disease-Diagnosis.aspx

Sampson S. (2018, January 19) Coronary Artery Disease Symptoms

https://www.healthline.com/health/coronary-artery-disease/symptoms#heart-attack

Ada Health GmbH 2020. (2018, December 4) Cardiovascular Disease Risk Factors. Retrieved
from: https://ada.com/cardiovascular-disease-risk-factors/