Pathophysiology

Patient History: MA., a 56 year old, Caucasian female with a long history of diabetes, tobacco

use, hypertension, and ulcers. Patient presented to the emergency room complaining of chest

pain that radiates to her neck and left shoulder. Patient further states that during periods of

compliance. She was brought to the ER by a concerned coworker. Temperature - 36.2C, Pulse -

Admitting diagnosis: Chest pain R/O Myocardial Infarction.

Pathophysiology: Increases in heart rate result in increased oxygen demand by the heart. The

heart has a limited ability to increase its oxygen intake during episodes of increased demand.

Therefore, an increase in oxygen demand by the heart has to be met by a proportional increase in

blood flow to the heart. If this demand is not met, pain will insue. Chest pain is a cardinal

symptom of cardiac disorders but can be precipitated by numerous other conditions which are

non-cardiac in nature; anxiety, musculoskeletal injuries, pulmonary disorders and gastric

disorders. Irritation of the small arteries supplying the heart with blood causes aggregation of

platelets. Repeated irritation or trauma from smoking, hypertension or high cholesterol creates

the predominant accumulation of plaques inside the artery causing stable angina, stenosis and

reduced blood flow. (Phipps, Monahan, Sands, Marek & Neighbors, 2003). Unstable angina

occurs when a portion of the plaque becomes unstable, either partially obstructing the bore of the

artery or it breaks off causing either temporary obstruction or arterial spasms. Myocardial

infarction results when the unstable angina fracture either closes the artery or a subsequent

fibrous platelet plug blocks the artery cutting off blood flow and oxygenation of