Guideline For The Evaluation and Diagnosis of Chest Pain Assignment
Week 3 Discussion Response 2
Chest pain is among the most common reasons adults present at the emergency department. Patients presenting to the emergency department with nontraumatic chest pain are often a diagnostic challenge. According to Gulati et al. (2021), the priorities are speedy initiation of optimal management in individuals with life-threatening conditions like pulmonary embolism, aortic dissection, and ACS (acute coronary syndrome) and also nonvascular syndromes such as tension pneumothorax and esophageal; and deliberate therapy for less critically ill patients. Although chest pain can be caused by several life-threatening conditions, it represents a moiré benign condition. Initial evaluation necessitates an ECG, but biomarkers, examination, history, and other aids are still fundamental. Guideline For The Evaluation and Diagnosis of Chest Pain Assignment
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A comprehensive history that captures all the features of chest pain including location and radiation; onset and duration; nature; precipitating and relieving factors; and associated symptoms is essential to help a clinician better recognize possible cardiac causes and needs to be obtained from every patient. Females presenting with chest pain are at risk of being underdiagnosed, and possible cardiac causes should be considered. In women who present with chest pain, clinicians are recommended to obtain a history that highlights accompanying symptoms that occurs more in females with ACS (Gulati et al., 2021).
The majority of patients with diabetes also have metabolic syndrome, a group of cardiovascular hazards related to both cardiovascular diseases and diabetes mellitus. Hussein et al. (2020) posit that patients with diabetes type 2 are two to three times more at risk for cardiovascular events compared to individuals without diabetes, and cardiovascular diseases caused around 80 percent of mortality in type 2 diabetes mellitus. It is important to manage hyperglycemia to lessen the long-term microvascular and macrovascular complications. Diabetic patients who are smokers or physically inactive have a greater lifetime hazard for cardiovascular disease. Guideline For The Evaluation and Diagnosis of Chest Pain Assignment
References
Gulati, M., Levy, P. D., Mukherjee, D…. Shaw, L. (2021) 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 144(22), e368-e454.
Hussein, A., Mahmoud, S.E., Awad, M. S., & Mahmoud, H. E. (2020). Assessment of Cardiovascular Risk Factors in Patients with Type 2 Diabetes in Upper Egypt
Villages. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 13, 4737-4746.
Please respond to the below post, no title page needed, at least two references which are not textbooks
It is essential that anyone who has chest pain should be assessed immediately for cardiovascular disease (Dunphy, et. al., 2019). Heart attacks are the leading cause of death in women in the United States and only half of the women realize it is the number one killer of women (CDC, 2022). Women typically experience pressure in their back, dizziness, lightheadedness, indigestion, heartburn, nausea, vomiting, shortness of breath and fainting when experiencing a heart attack (American Heart Association, 2015).
This young woman should be evaluated through a thorough history and physical exam along with an ECG, CBC, ESR, serum electrolytes, BUN, serum creatinine, and cardiac troponins (Dunphy, et. al., 2019). The differential diagnosis could also include: gastroesophageal reflux, anxiety, musculoskeletal, and pulmonary (Dunphy, et. al., 2019). When assessing this young womanâ€
s symptoms, the healthcare provider should assess the location, duration, quality, aggravating or relieving factors, and if it is localized or does the pain move (Dunphy, et. al., 2019). If a myocardial infarction is rule out, then other emergencies such an aortic dissections and pulmonary embolism should be looked at (Dunphy, et. al., 2019). Guideline For The Evaluation and Diagnosis of Chest Pain Assignment
Patients with diabetes have atypical or minimal symptoms with a myocardial infarction because the nerves are damaged in the heart and pain is blunted (Dunphy, et. al., 2019). Coronary artery disease begins with endothelial injury and many causes are hypertension, hyperglycemia of diabetes, and free radicals (Dunphy, et. al., 2019). This endothelial injury results in an inflammation response attracting platelets, macrophages, and T cells (Dunphy, et. al., 2019).
The patient should be asked if they smoke because smoking is a modifiable risk factor this patient can change to reduce her risk of cardiovascular disease (Dunphy, et. al., 2019). If the patient does smoke, the patient should be assessed if they are ready to stop smoking (Dunphy, et. al., 2019). To assist in cessation of smoking, the healthcare provider can offer nicotine replacement therapy are effective ways to stop smoking (Dunphy, et. al., 2019). In addition, education on the risks of smoking and benefits of quitting should be discussed with the patient, along with controlling her diabetes (Dunphy, et. al., 2019).
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Center for Disease Control and Prevention (2022, February 4). Lower your risk for the number 1 killer of women. Retrieved December 3, 2022 from https://www.cdc.gov/healthequity/features/heartdisease/index.html
Dunphy, L. M., Winland-Brown, J. E., Porter, B.O. & Thomas, D.J. (2019). Primary care: The art and science of Advanced Practice Nursing (5th ed.). Philadelphia, PA: F. A. Davis Co. Guideline For The Evaluation and Diagnosis of Chest Pain Assignment