NURS 6501 Case Study Analysis: Cardiovascular And Cardiopulmonary

Case Study Analysis: Cardiovascular and Cardiopulmonary This paper will discuss the following case study: A 65-year-old patient is 8 days post op after a total knee replacement. Patient suddenly complains of shortness of breath, pleuritic chest pain, and palpitations. On arrival to the emergency department, an EKG revealed new onset atrial fibrillation and right ventricular strain pattern – T wave inversions in the right precordial leads (V1-4) ± the inferior leads (II, III, aVF). The purpose of this paper is to analyze the above case study and explain cardiovascular and cardiopulmonary pathophysiologic processes, how these processes interact to affect the patient and any racial or ethical variables that result in the patient presenting these symptoms. Cardiovascular and Cardiopulmonary Pathophysiologic Processes The patient’s history and current symptoms show a pulmonary embolism (PE). The patient most likely had a deep vein thrombosis (DVT) that broke loose and lodged in the pulmonary artery. The DVT is associated with the patient’s age, orthopedic surgery, immobility, and hospital stay after surgery (McCance & Huether, 2019). Pulmonary embolism is an occlusion or partial occlusion of the pulmonary artery from embolization of a clot from a DVT involving the lower extremity (McCance & Huether, 2019). A pulmonary embolism blocks the flow of blood within the pulmonary circulation (Clark, Xue, & Sharma, 2019). A PE lodged in the pulmonary circulation causes a release of neurohumoral substances and inflammatory mediators that cause vasoconstriction that further impedes oxygenation (McCance & Huether, 2019). This results in pulmonary artery pressures that make it difficult for the right ventricle to pump blood and causes hypertrophy of the thin-walled heart muscle (McCance & Huether, 2019). The damage to the heart muscle causes right ventricular strain (McCance & Huether, 2019). Studies show a PE increases the prevalence of atrial fibrillation (Ng et al., 2016).