Chest Pain Scenario Case Assignment

Develop a 1–2-page case study analysis including the genetic principles as they relate to the patient in the Chest Pain Scenario (Links to an external site.).

In your assignment:

· identify genes associated with the disease,

· the effects genetics have on the body of a patient with this chief complaint and diagnosis, and

· note the education you would provide the patient related to CAD/HTN and genetics.

Provide three provider-based scholarly references that are applicable to your case. Utilize APA 7th Edition (2020).

1, All information is accurate for the case study, symptomatology, and findings as they apply to the pathological process.

2, All information is accurate for pathological content as it applies to the questions asked.

3, All three scholarly sources are provider-based and are applicable to the case study. APA errors in the reference list are zero to one.

CHEST PAIN SCENARIO TRANSCRIPT

This case scenario takes you through a visit with an adult patient who has come to the urgent care clinic with complaints of a chest pain. Use the information provided, along with acquired knowledge from course materials, to complete the case scenario.

Meet Frank Spector, a 58-year-old white male with complaints of chest pain.

Nurse Practitioner (NP): Hello, Frank. What brings you here today?

Frank: Hi, I have been having this awful pain in my chest.

NP: Where did the pain start? What were you doing when the pain started?

Frank: It began as a dull pain in my chest and moved down my left arm. I had just finished dinner.

NP: Have you been experiencing any other symptoms?

Frank: Yes. The chest pain seems to make me feel nauseated and a little dizzy.

What Could Be The Pathology?

What could be causing Frank’s chest pain? Select which three of the following may be responsible for Frank’s chest pain.

ST-Elevation Myocardial Infarction (STEMI) ans

Non-ST-Elevation Myocardial Infarction (NSTEMI) ans

Pleural Effusion

Pulmonary Embolism

Acute Coronary Syndrome answer

Stroke

Acid Reflux

Cholecystitis

Thoracic Compression Fracture

Hiatal Hernia

Correct

Left-sided chest pain radiating to the left arm is very likely cardiac in nature. You are correct.

STEMI, NSTEMI, and Acute Coronary Syndrome

Frank’s Chart Information

Past medical history

DM type 2

HTN

HLD

Medications

Metformin

Lantus

Lisinopril

Pravastatin

ASA

Frank Responds Transcript

Nurse Practitioner (NP): Tell me Frank, have you gained or lost any weight?

Frank: Ah, I ‘ve gained about 10 pounds. I ate a lot of ham during the holidays.

NP: Have you noticed any changes in your vision?

Frank: No, no changes.

NP: Any sore throat or nasal congestion?

Frank: No, no sore throat or nasal congestion.

NP: When did you notice the pressure in your chest?

Frank: For the past two days I have been feeling this pain in my chest, especially when I go up the stairs. That’s when I noticed it first.

NP: Have you been coughing or wheezing?

Frank: No, none of those.

NP: Have you noticed any changes in skin, any swelling?

Frank: Yeah, my ankles feel a little tighter. The skin looks shinier. I think they may be a little more swollen than usual.

Frank’s Physical Exam Information

After completing the review systems, you conduct a physical exam of Frank and note the following results:

· VS: BP 100/68 P 110 R 24 T 98.6

· General: alert, appears in some distress

· HEENT: nose is clear, throat is without edema, thyroid is midline

· Cardio: tachycardic, no murmurs noted, no lifts or heaves. JVD is present

· Respiratory: lungs have some crackles in bilateral bases

· Skin: 3 + pitting edema noted in bilateral ankles

· Neuro: alert and orientated x 3

Frank’s Test Results

After completing your review of his systems and a physical exam, you send Frank to radiology and to the lab for a few tests. You receive these results:

Radiology

· CXR shows left ventricle enlargement

· CXR is normal

Labs

· BNP is elevated at 4200

· Troponin is elevated at 1.2

· D-Dimer is normal

· Liver function tests: all within normal limits

· Bilirubin is normal

Other Pertinent Information

· EKG is normal

· Pain is improved with oxygen and nitroglycerin

· Pathology

· Now that you have completed your visit with Frank and reviewed his test results, which of the following is the most likely pathology?

· STEMI

· NSTEMI

· Acute Coronary Syndrome

· Correct

· Based on patient presentation, supporting laboratory results, and other data, you are correct.