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The cardiovascular and cardiopulmonary pathophysiologic processes

The cardiovascular and cardiopulmonary pathophysiologic processes

 

Case Study Scenario 6

Patients with diabetes often present with hypertension, a risk factor for other diabetic complications, including cardiovascular events. In this case study, the patient presents with chronic kidney disease and heart failure symptoms. Understanding the pulmonary and cardiovascular processes that lead to these conditions is crucial for practitioners in making diagnostic and treatment decisions. The purpose of this paper is to evaluate the pathophysiological processes related to pulmonary and cardiovascular processes presented in the case study.

The cardiovascular and cardiopulmonary pathophysiologic processes

Cardiac troponins are the sole biomarkers for determining the presence of acute myocardial infarction (AMI) (Stark et al., 2022). In people with chronic kidney disease, as presented in the case study, troponin elevation is related to cardiac injury rather than acute ischemia. The mechanism involved in the pathophysiological pathway starts with cardiac injury associated with heart failure or coronary heart disease (Wu, 2018). Injury causes blockage of blood flow through the coronary arteries, preventing oxygen supply to the heart muscles. Similarly, such damage can also occur in the pulmonary veins, causing a pulmonary embolism, which prevents the lungs from supplying the lungs to the heart. The patient cites edema, a clinical manifestation of pulmonary embolism (Chauin, 2021). When the blood supply to the heart is limited, a mismatch occurs between the available oxygen and the amount of oxygen required by the myocytes. Failure to meet the oxygen demand causes cell death and necrosis as the cell membranes rupture. The ra

The cardiovascular and cardiopulmonary pathophysiologic processes 

ptured cells spill the intracellular contents into the extracellular space, which goes into the bloodstream (Pouru et al., 2020). Among the spilled substances are the troponins, which are measured to confirm an acute myocardial infarction. Hence, troponin elevation in the patient is due to the series of cardiac and pulmonary processes ignited by the injury of a cardiac muscle.

Racial/ethnic factors

Racial/ethnicity is a risk factor for cardiovascular conditions such as heart disease or heart failure. African-Americans, followed by Hispanics, are more vulnerable to heart failure than Whites. For instance, an African American with diabetes will be at high risk of developing heart disease or heart attack compared to a White patient with diabetes (Muncan, 2018). Hence, people from the African-American community are likely to experience worsening complications of diabetes-related to cardiovascular events.

How the processes affect the patient

The patient presents with several symptoms, including jaw pain that radiates to the neck, proteinuria, little voiding, high blood pressure, and non-fasting glucose of 410. These conditions point to uncontrolled blood sugar levels. High blood sugar levels and high blood pressure are risk factors and complications of each other, leading to processes that affect the patient. For example, a combination of high blood pressure and uncontrolled glucose levels in people with diabetes results in chronic kidney disease (CKD) (Vieira et al., 2029). Furthermore, uncontrolled hypertension worsens CKD, which might cause kidney failure. The effects of CKD manifest in edema, proteinuria, and elevated levels of non-fasting glucose. Similarly, hypertension is linked to cardiovascular events such as heart disease or heart failure. Hypertension causes damage to the arteries supplying blood to the brain, which either rapture or become blocked, interfering with blood flow. In severe cases, this causes heart failure, whose effects in the patient include high troponin levels and chest/jaw pain radiating to the back of the neck.

Conclusion

The patient presents with a complex case of diabetes, chronic kidney disease, and heart failure. The symptoms reported are due to these conditions. The pathophysiology that leads to the release of troponin starts with the hypertensive condition that causes cardiac injury, which initiates a series of events characterized by a reduced supply of oxygenated blood to the heart and other parts of the body, including the brain. Racial/ethnic origins affect physiological processes in people with diabetes because of susceptibility to cardiovascular events associated with African-Americans and Hispanics.

 

References

Chauin, A. (2021). The Main Causes and Mechanisms of Increase in Cardiac Troponin Concentrations Other Than Acute Myocardial Infarction (Part 1): Physical Exertion, Inflammatory Heart Disease, Pulmonary Embolism, Renal Failure, Sepsis. Vascular Health and Risk Management, 17, https://doi.org/10.2147/VHRM.S327661.

Muncan, B. (2018). Cardiovascular disease in racial/ethnic minority populations: illness burden and overview of community-based interventions. Public Health Rev, 39, 32. https://doi.org/10.1186/s40985-018-0109-4.

Pouru, J., Jaakkola, S., Biancari, F., Kiviniemi, T., Nuotio, I., & Airaksinen, K. (2020). Association of Heart Rate With Troponin Levels Among Patients With Symptomatic Atrial Fibrillation. JAMA Netw Open, 3(9):e2016880. doi:10.1001/jamanetworkopen.2020.16880.

Stark, M., Kerndt, C., & Sharma, S. (2022). Troponin. Treasure Island (FL): StatPearls Publishing.

Vieira, M. B., Neves, J., Leitão, L., & Baptista, R. (2029). Impaired Fasting Glucose and Chronic Kidney Disease, Albuminuria, or Worsening Kidney Function: A Secondary Analysis of SPRINT. The Journal of Clinical Endocrinology & Metabolism, 104(9), 4024–4032, https://doi.org/10.1210/jc.2019-00073.

Wu, A. H. (2018). Release of cardiac troponin from healthy and damaged myocardium. Frontiers in Laboratory Medicine, 1(3), 144-150. https://doi.org/10.1016/j.flm.2017.09.003.

  Excellent Good Fair Poor
Main Posting 45 (45%) – 50 (50%)

Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

 

Supported by at least three current, credible sources.

 

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

40 (40%) – 44 (44%)

Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

 

At least 75% of post has exceptional depth and breadth.

 

Supported by at least three credible sources.

 

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

35 (35%) – 39 (39%)

Responds to some of the discussion question(s).

 

One or two criteria are not addressed or are superficially addressed.

 

Is somewhat lacking reflection and critical analysis and synthesis.

 

Somewhat represents knowledge gained from the course readings for the module.

 

Post is cited with two credible sources.

 

Written somewhat concisely; may contain more than two spelling or grammatical errors.

 

Contains some APA formatting errors.

0 (0%) – 34 (34%)

Does not respond to the discussion question(s) adequately.

 

Lacks depth or superficially addresses criteria.

 

Lacks reflection and critical analysis and synthesis.

 

Does not represent knowledge gained from the course readings for the module.

 

Contains only one or no credible sources.

 

Not written clearly or concisely.

 

Contains more than two spelling or grammatical errors.

 

Does not adhere to current APA manual writing rules and style.

Main Post: Timeliness 10 (10%) – 10 (10%)

Posts main post by day 3.

0 (0%) – 0 (0%) 0 (0%) – 0 (0%) 0 (0%) – 0 (0%)

Does not post by day 3.

First Response 17 (17%) – 18 (18%)

Response exhibits synthesis, critical thinking, and application to practice settings.

 

Responds fully to questions posed by faculty.

 

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

 

Demonstrates synthesis and understanding of learning objectives.

 

Communication is professional and respectful to colleagues.

 

Responses to faculty questions are fully answered, if posed.

 

Response is effectively written in standard, edited English.

15 (15%) – 16 (16%)

Response exhibits critical thinking and application to practice settings.

 

Communication is professional and respectful to colleagues.

 

Responses to faculty questions are answered, if posed.

 

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

 

Response is effectively written in standard, edited English.

13 (13%) – 14 (14%)

Response is on topic and may have some depth.

 

Responses posted in the discussion may lack effective professional communication.

 

Responses to faculty questions are somewhat answered, if posed.

 

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

0 (0%) – 12 (12%)

Response may not be on topic and lacks depth.

 

Responses posted in the discussion lack effective professional communication.

 

Responses to faculty questions are missing.

 

No credible sources are cited.

Second Response 16 (16%) – 17 (17%)

Response exhibits synthesis, critical thinking, and application to practice settings.

 

Responds fully to questions posed by faculty.

 

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

 

Demonstrates synthesis and understanding of learning objectives.

 

Communication is professional and respectful to colleagues.

 

Responses to faculty questions are fully answered, if posed.

 

Response is effectively written in standard, edited English.

14 (14%) – 15 (15%)

Response exhibits critical thinking and application to practice settings.

 

Communication is professional and respectful to colleagues.

 

Responses to faculty questions are answered, if posed.

 

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

 

Response is effectively written in standard, edited English.

12 (12%) – 13 (13%)

Response is on topic and may have some depth.

 

Responses posted in the discussion may lack effective professional communication.

 

Responses to faculty questions are somewhat answered, if posed.

 

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

0 (0%) – 11 (11%)

Response may not be on topic and lacks depth.

 

Responses posted in the discussion lack effective professional communication.

 

Responses to faculty questions are missing.

 

No credible sources are cited.

Participation 5 (5%) – 5 (5%)

Meets requirements for participation by posting on three different days.

0 (0%) – 0 (0%) 0 (0%) – 0 (0%) 0 (0%) – 0 (0%)

Does not meet requirements for participation by posting on 3 different days.

Total Points: 100

 

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Important information for writing discussion questions and participation

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

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Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

  • Your response needs to be a minimum of 150 words (not including your list of references)
  • There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
  • Include in-text citations in your response
  • Do not include quotes—instead summarize and paraphrase the information
  • Follow APA-7th edition
  • Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

  • A minimum of 6 responses per week, on at least 3 days of the week.
  • Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
  • Each response needs to be at least 75 words in length (does not include your list of references)
  • Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
  • Follow APA 7th edition
  • Points will be deducted if the above is not followed
  • Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
  • Here are some helpful links
  • Student paper example
  • Citing Sources
  • The Writing Center is a great resource