How likely is this to be a heart problem, asthma, or panic attack?

Denises case is truly likely to be a content advance or what is medically known as the acute myocardial infarctionion (MI). Asthma was eliminated in the diagnosis because thither was no prior indication that Denise had been exposed to allergens, sensitizer, irritants or any homunculus of air pollution. Asthma is associated with inveterate inflammation of the lower respiratory share and requires a triggering factor like one of those mentioned above (Fauci, et al., 2008).Cardiac ischemia was likewise considered but was eliminated because of the absence of its hallmark symptom of angina pectoris. An asymptomatic cardiac ischemia was also not considered because Denise stupefys some symptoms like son of a bitch or dyspnoea, anxiety, irregular beating of the heart and cold sweating. These symptoms, however, are present in botherless acute myocardial infarction.It had also been indicated in some(prenominal) studies that cigarette smoking also increases the risk of MI (Fauci, et a l., 2008). Although Denise had not been smoking, she is in close association with someone who had been a chronic cigarette smoker, her husband. It could be inferred that Denise had suffered from second hand smoking and is, therefore, at risk of having a heart disease, too.2. Why do you say this? What are the symptoms that are consistent with your approach diagnosis? Is there anything unusual?Myocardial infarction usually presents with pain as the chief complaint of the patient. The pain felt was usually exposit as heavy, squeezing, and crushing. In rare cases, the pain is also described as stabbing or burning. It is precise similar to the pain experience in cases of angina pectoris or chest pain. However, pain of MI usually occurs at rest, more severe, and lasts longer.In our case, however, no pain was felt. Nevertheless, this is not to be utilise as a basis in eliminating the possibility of MI. The clinical unveiling of Denises case is termed as the painless myocardial infarct ion. The proportion of painless MI is heavy(p)er in elderly patients and is and usually presents with breathlessness, appearance of an arrhythmia, and a sensation of pro raise weakness (Bayer, Chadha, Farag, & Pathy, 1986).An arrhythmia is the medical term referring to irregular beating of the heart. Denises case is a type of arrhythmia called tachycardia or the abnormal increase in heart rate, i.e. heart is beating genuinely fast (Guyton, 2006). MI, in general, is also accompanied by sweating, anxiety, and a scent out of impending doom (Fauci, et al., 2008). All these clinical presentations had been experienced by Denise.The type O-poor ancestry from the (1) right atrium empties to the (2) right ventricle, which then(prenominal) pumps blood to the (3) pulmonary artery. The blood then enters the pulmonary circulation through the (4) pulmonary arterioles and pulmonary capillaries where exchange of gases takes place.The oxygen-rich blood the goes plunk for to the heart via the ( 5) pulmonary vein and empties to the (6) go forth atrium and then passes to the (7) left(p)(a) ventricle. The left ventricle then pumps the oxygen-rich blood to the (8) aorta, the largest artery, and flows through the large (9) systemic arteries to pull in the organs they supply.The blood then flows through (10) arterioles and (11) capillaries of the organs to deliver oxygen and nutrients. Cellular waste products and carbon dioxide are exchanged for nutrients and oxygen at the level of the capillaries.The blood then passes through the (12) venules and then to the (13) larger veins. riptide from the upper part of the body, e.g. head and upper extremities, drains into the (14) A-one vena cava. line of descent from the lower part of the body, e.g. stomach, intestines, and lower extremities, drains into the (15) inferior vena cava. Both the superior and inferior vena cava drains into the right atrium (Guyton, 2006).3. What are the characteristics of Denises lifestyle that expone nt lead to a heart problem?Denises genetic cook up predisposes her to hypercholesterolemia. However, her diet aggravates her situation and causes her blood cholesterol level to be higher(prenominal) than normal. It has been shown that hypercholesterolemia induces the formation of atherosclerosis (Prassad & Kalra, 1993).The disruption of atherosclerotic plaques attracts platelets and promotes the formation of thrombus or blood clot leading to obstruction of blood supply to the heart. Hence, patients with hypercholesterolemia are at very high risk of having myocardial infarction.From the case, it could also be gathered that Denise is closely associated with a man who had been a chronic cigarette smoker and that she has been exposed to second hand smoking. Smoking had been found in many studies to be associated with the increased risk of myocardial infarction. baccy contains nicotine that promotes vascular constriction and aggravates the narrowing of vessels caused by of atherosclero sis (Wilhelmsson, Vedin, Elmfeldt, Tibblin, & Wilhemsen, 1975 Rosenber, Plamer, & Shapiro, 1990).Denise had also been undergoing a lot of emotional and physical stress, which had been found to trigger acute MI (Gelernt & Hochman, 1993). Also there are several facts that point to Denises sensitivity to MI such as aging and being in advance(prenominal) menopausal stage (Rosenberg, Hennekens, Rosner, Belanger, & Speizer, 1981).4. Has Denise suffered a heart attack?Indeed, Denise had suffered from heart attack or acute myocardial infarction (MI). However, her case might, in the advance(prenominal) part of the case, have only been a painless and mild MI. The infarct located on her left ventricle. This is due to the obstruction on her left anterior descending artery, the major blood supply of the left ventricle.The left ventricle is a high pressure chamber and, therefore, demands a very high blood supply. Her case may have developed oer the years such that angiogenesis, i.e. formation o f new blood vessels, or the orifice of collateral vessels had provided her with heart enough blood that the infracted portion is not very great (Fauci, et al., 2008). She also presents the symptoms typical of older women presenting painless MI with dyspnea or what is commonly known as breathlessness, anxiety, tachycardia, and sweating.5. Define the following price cholesterol, hypercholesterolemia, cardiac ischemia, collateral vessels, angina pectoris, and plaque.Cholesterol is the best know steroid believably because of its association with atherosclerosis and other various heart disease. Biochemically, it is also of great importance because it is the precursor of equally important steroids that include the adrenocortical hormones, awake hormones, vitamin D, and bile acids. It occurs in animals but not in plants or bacteria. digit 4 shows the chemical structure of cholesterol (Murray, Granner, & Rodwell, 2006).