Do you have the answers to anyone who had a heart case study in physiology by Phil Stephens?

Case Study: Heart Failure

Patient: Mr. Smith

Age: 55

Sex: Male

Medical History: Hypertension, diabetes, hyperlipidemia

Social History: Smoker, drinks alcohol socially

Chief Complaint: Shortness of breath

Physical Examination

- Vital signs:

- Blood pressure: 160/90 mm Hg

- Pulse: 110 bpm and irregular

- Respirations: 24 bpm

- Temperature: 37.5°C (99.5°F)

- General appearance: Mr. Smith is a well-developed, well-nourished male in moderate distress. He is sitting upright in bed and using accessory muscles of respiration.

- Neck: No jugular venous distension.

- Lungs: Auscultation reveals bibasilar rales.

- Heart: Auscultation reveals a regular rhythm with an S3 gallop. There are no murmurs, rubs, or gallops.

- Abdomen: Soft, non-tender, no masses or organomegaly.

- Musculoskeletal: No edema, clubbing, or cyanosis.

Laboratory Studies

- Complete blood count: Normal

- Comprehensive metabolic panel:

- Sodium: 138 mEq/L (normal range: 135-145 mEq/L)

- Potassium: 4.0 mEq/L (normal range: 3.5-5.0 mEq/L)

- Chloride: 105 mEq/L (normal range: 98-110 mEq/L)

- Bicarbonate: 24 mEq/L (normal range: 22-26 mEq/L)

- BUN: 25 mg/dL (normal range: 10-20 mg/dL)

- Creatinine: 1.2 mg/dL (normal range: 0.8-1.5 mg/dL)

- Glucose: 140 mg/dL (normal range: 70-100 mg/dL)

- Lipid panel:

- Total cholesterol: 250 mg/dL (normal range: < 200 mg/dL)

- Triglycerides: 150 mg/dL (normal range: < 150 mg/dL)

- LDL cholesterol: 170 mg/dL (normal range: < 130 mg/dL)

- HDL cholesterol: 45 mg/dL (normal range: > 40 mg/dL)

Imaging Studies

- Chest x-ray: Mild cardiomegaly.

- Echocardiogram: Left ventricular ejection fraction: 30%.

Diagnosis

- Heart failure with reduced ejection fraction

Treatment Plan

- Medications:

- ACE inhibitor (e.g., lisinopril)

- Beta-blocker (e.g., metoprolol)

- Diuretic (e.g., furosemide)

- Lifestyle modifications:

- Smoking cessation

- Weight loss

- Regular exercise

- Sodium restriction

Prognosis

With optimal medical therapy and lifestyle modifications, Mr. Smith's prognosis is good. He is likely to experience improvement in his symptoms and a reduction in his risk of heart failure-related complications.