Heart Surgeries

Heart Patient X Case Study

Patient: Mr. X

Age: 47

Height: 6’1”

Weight: 235 lbs

History: Mr. X was recently laid off from his stressful job as a real estate agent due to the failing economy. Now his stress level has skyrocketed as he is searching for a job. (He has two teenage children that he must send to college in the next few years and without a job, he won’t have the money to support them.) With no income, he can only afford to eat highly processed fast foods that contain little nourishment. Mr. X was feeling tightness, aching and discomfort in his chest. He initially thought it was heartburn or indigestion and took an over-the-counter drug, Pepto Bismol in hopes that it would go away. His chest pain, called angina, has since worsened and now he is also feeling shortness of breath.

Family History: His mother’s side of the family has a history of obesity and heart attacks.

Tests: Mr. X’s physical examination depicted that he has high blood pressure (hypertension). The EKG test checked for problems with the electrical activity of Mr. X’s heart. These showed that Mr. X had an abnormal heart beat and that there was an underlying problem. An electron-beam computed tomography (EBCT) was performed on Mr. X, which illustrated how severely the calcium build-up in the lining of his arteries had become. The final test, an angiocardiography, was able to show us a radiographic examination of the heart chambers and thoracic vessels by the injection of radiopaque dye. This heart x-ray determined the extent of Mr. X’s coronary artery disease.

Pulmonary Arterial Hypertension and calcium build up in Mr. X’s heart

Diagnosis: Mr. X has coronary heart disease, which is a disease that develops when a combination of fatty material, calcium and scar tissue (plaque) builds up in the arteries that supply the heart with blood. The build up narrows the arteries so that the heart does not get enough blood, causing chest pain (angina) and ultimately if left untreated, a heart attack (myocardial infarction) or a fatal rhythmic disturbance (cardiac arrest).

Treatment: Mr. X should get a coronary bypass to relieve his pain.  This is an invasive surgical procedure performed to improve blood supply to the heart by creating new routes for blood flow since the old routes have been obstructed by plaque build up. The surgery requires the removal of a healthy blood vessel from another part of the body, such as the arm or leg, so that it can be grafted onto the heart to circumvent the blocked artery. Mr. X should also make lifestyle changes, such as reducing his stress level and eating healthier so that he can reduce the risk of worsening his disease. If he does not make these lifestyle changes, Mr. X will likely end up having a heart attack and would need a heart transplant. This would entail removing the diseased heart and replacing it with a new, healthy heart. Transplants can be risky and are not always successful. It would be best if Mr. X made lifestyle changes now and did not go down the path of heart failure before it is too late.