Review Note
Last Update: 01/29/2025 02:44 PM
Current Deck: PHYSIOLOGY::exam one
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Commit #272787Marvin
Zimmerman is a 52 manager, significantly overweight, eats rich diet (red meats,
desserts), several beers each evening.
Experiences occasional angina, relieved by nitroglycerin.
Marvin
goes to bed early not feeling well, wakes at 2am with crushing chest pressure,
pain radiating down left arm. No relief
from nitroglycerin, nauseated, sweating, dyspnea, especially when recumbent
(orthopnea). Breathing “noisy”. Paramedics called, transported to hospital.
In
ER, bp was 105/80, inspiratory rales present (pulmonary edema), skin cold and
clammy. Electrocardiograms and serum
cardiac enzymes suggest left ventricular wall myocardial infarction. Pullmonary
capillary wedge pressure was 30mmHg (normal is 5 mmHg), ejection fraction is
.35 (normal is .55).
Pt
transferred to coronary ICU, treated with thrombolytic agent, digitalis
(positive inotropic agent), and furosemide (loop diuretic). After 7 days, sent home on low-fat, low-Na
diet.
Question: Which information tells you that Marvin's stoke volume was decreased?
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Commit #272787
The most specific information indicating patient's stroke volume was decreased is his pulse pressure. This is the difference between systolic and diastolic blood pressure. Patient had 105/80, for a pulse pressure of 25 mmHg. Normal is 120/80, for pulse pressure of 40 mmHg. Stroke volume, the volume ejected from ventricle in systole, increases arterial pressure from diastolic to systolic levels.
