44 Differential Diagnosis for PT: Hematological, Cardiovascular, Immune, and Digestive System Disorders: Summary
Myocardial Infarction (MI) Occurs when coronary artery is totally obstructed, which leads to prolonged ischemia or infarction of the heart tissue. The most common cause of an MI is atherosclerosis. The size and location of the MI determine the severity of damage. Area of necrosis is gradually replaced with fibrous tissue. Symptomology in Females • More likely than men to have MI without chest pain • After MI, more likely to die in the hospital than men • Less likely to receive cardiac catheterization, a key test to determine optimal treatment • Develop heart disease about 10 to 15 years later than men, largely because of the cardio-protective effect of female hormones
Bradycardia Heart rate slower than 60 bpm Tachycardia Heart rhythm disorder with heartbeats faster than usual, greater than 100 bpm Sick Sinus Syndrome When the sinus node—the heart's natural pacemaker—doesn't reliably trigger every heartbeat; patient experiences both brady- and tachycardia • Seen more frequently in older adults • Symptoms: Fluttering in the chest, chest pain, fainting, dizziness Premature ventricular contractions (PVCs) Additional beats that if frequent interfere with heart function and can lead to arrest
LEARNING TIP! Common pre–heart attack
symptoms in females: unusual fatigue, sleep disturbance, shortness of breath, chest pain, indigestion, anxiety, pain in shoulder blade or upper back.
Congestive Heart Failure (CHF): Occurs when heart is unable to pump sufficient blood to meet the body’s metabolic needs • Left-sided: Left ventricle can’t pump out enough blood → blood gets backed up in the lungs → pulmonary edema, which brings about SOB ○ Left-sided heart failure often leads to right-sided heart failure • Right-sided: Right ventricle cannot pump out enough blood → fluid gets backed up in the veins and then in capillaries of the body → fluid leaks out of the capillaries and builds up in the tissues, a condition called systemic edema ○ Edema especially noticeable in lower extremities
• General signs and symptoms ○ Sudden substernal chest pain ○ Pallor and sweating ○ Marked anxiety/fear ○ Nausea, dizziness, dyspnea ○ Rapid weak pulse with hypotension Cardiac Arrhythmias Alterations in cardiac rate due to electrolyte abnormalities, fever, hypoxia, stress, infection, drug toxicity or damage to the heart’s conduction system (scar tissue from rheumatic fever or MI) • Reduce the heart’s pumping cycle efficiency ○ Sinus node abnormalities
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