is aged 60 years. She worked in the bakery shop. However, she would retire
soon. The patient came up with severe complains of shortness of breath as well
as nonproductive coughing in the last few days of the visit. She was suffering
from this condition for almost one month or so. As a result, she also said that
her efficiency was not at par with the past records. It was more because of
excessive tiredness that she underwent through. At times, the patient was
unable to breathe so much that she spent many nights on the recliner, in order
to breathe properly. During the interrogation rounds and check-ups, she hardly
complained about any type of pain in her chest along with sweating and nausea. It
was furthermore, crucial to go through her earlier reports on coronary artery
disease and blood pressure. They both were instrumental in providing an idea of
her condition and its root-causes. When the client was 40 years old, she had
heavy bleeding in vagina, which ultimately led to hysterectomy. She was about
to take retirement from the bakery industry. Her status was married. In case of
substance abuse, she was far from the same. Hence, she was reluctant to agree
regarding her consumption of drugs, alcohol or tobacco. It was also noted that
the client did not have any type of upper respiratory illness, at least in the
recent past. There was no such distress that was acute. The pulse rate was
around 100, while her blood pressure was accounted as 160 by 100.
The family history of this patient
also vital for understanding the diseases that were studded in her genes. For
instance, her father’s death was caused by nothing but the fatal prostate
cancer. Alternatively, her mother largely died out of cardiac arrest. The
diagnoses depicted that the S3 could be heard from top, while S2 and 1 were
The four most chest diseases that are
subject of differential diagnosis include the right-sided heart failure, cardiac
tamponade, COPD i.e., chronic obstructive pulmonary ailment, and left-sided
It is quite noteworthy that the S3
sound is produced by the surge in fluid states inside the heart. Thus, it can
be said the symptoms indicate more of left-sided failure in heart (Gustafsson & Rogers, 2017). On the other
hand, the heart’s fluid may start moving towards the lungs as insufficient
space is available in the former to retain the excess fluid. Therefore, the
lower lobes’ bases cause the crackle sounds, once the fluid is collected on
various dependent areas (Guazzi & Borlaug,
2012). It is also understandable from the patient’s urge to sit at
nights, for comfortable breathing. There are two primary reasons due to which
the above-mentioned symptoms can come to the forefront, such as the coronary
heart ailment and surged BP, ultimately manifesting in the form of reduced
heart contractility and myocardial ischemia.
Treatment plan suggestion
It would be
best to follow a holistic treatment plan than anything else. Thus, the
lifestyle and eating habits should be modified to a large extent. The patient
was definitely over-active. As a result, it is important to ensure that more
amount of rest is taken by her. Now that she is retiring, enough time can be
availed for resting. Another important aspect is diet. Her diet has to be
fat-free and low sodium formulation (Aranceta
& Pérez-Rodrigo, 2012). Moreover, instead of higher portion per
meal, it would be better to opt for smaller portions and ease the metabolic
system, all together. Conversely, vitamin rich foods along with better
supplements can give her the required energy. Additionally, meditation and
weight-loss exercises are also suggested for faster recovery. The fluid
retention must be controlled at any cost (Ross,
Caballero, Cousins, Tucker & Ziegler, 2014). Some of the medicines
that can be prescribed are Diamox, Lasix, Torsemide, Enduron, Zide-50 and
others. If all these things fail to work then either a pacemaker has to be
planted or heart repair transplant should be done, such as surgery for
inserting artificial heart valve.
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