I have 4 case study that i need help i already upload i need to done by june 2

Bio 2256

Name:____________________________________________

Case Study 1

Below are four (4) narratives about heart physiology, answer the questions associated with each. You may work in small groups, but make sure that each team member turns in a sheet with their name on it. Feel free to ask questions to clarify any of the information below.

1: Frank an otherwise healthy young man of 24 goes into his doctor’s office complaining of experiencing periods of rapid heartbeat accompanied by extra strong (thumping) beats. At the time of the visit his ECG is normal and his blood pressure is 115/75. The doctor asks Frank some general history questions and finds out that he does not drink or smoke, has no history of heart disease in his family, but for the past few months has been under a lot of stress (new baby, new job) and hasn’t been sleeping and has been drinking more coffee than normal. The doctor asks Frank to come in tomorrow for a stress test to try to determine what is going on.

Question 1: What do you think the doctor suspects is affecting Frank’s heart? Defend your answer?

Frank comes back the next morning and undergoes a stress test, which produces the phenomenon that Frank was complaining about. After looking at the results of the ECG and the stress test, the doctor tells Frank that his heart overall looks healthy, but his ECG showed several PVC’s, due to a ventricular ectopic focus.

Question 2: What is an ectopic focus and why is it producing the increased heart rate and thumping heart beat? What is a PVC and how is it caused by an ectopic focus?

Question 3: Draw an ECG that would represent what is going on in Frank’s heart.

Question 4: What do you think is causing Frank’s problems; do you think it is anything serious? If you were Frank’s doctor what advice would give him?

2: Mary a 55 year old mother of 6 is taken to the emergency room complaining of heart palpitations, chest pain, and an overall feeling of being light headed. In the ER her heart rate is highly elevated, but her pulse is both weak and does not match her heart rate.

Question 1: With the information provided, what do you think might be ailing Mary?

What could be causing her weak pulse, what is the term given when pulse and heart rate do not match?

Mary is hooked up to the ECG, which shows both a rapid heart (155 b/min) and irregular heart rate. The incoming cardiologist looks at the lack of true P waves on the ECG and immediately knows what is causing Mary’s symptoms.

Question 2: What does the P wave on an ECG represent? What would the lack of true P waves represent; what is afflicting Mary?

Question 3: How would your diagnosis cause the symptoms Mary is experiencing, be sure to explain the rapid heart rate, light headedness, and miss matched pulse and heart rate.

Question 4: Draw and ECG that would represent what is going on in Mary’s heart.

3: Mark a 82 year old man retired teacher is rushed to the hospital complaining of chest pain, pain radiating down his left arm, shortness of breath, and nausea.

Question 1: What do think is causing Mark’s symptoms.

Below is Mark’s ECG taken at the hospital.

Question 2: Does this ECG support your diagnosis above? What is abnormal about this ECG?

Soon after entering the hospital Mark regresses into ventricular fibrillation, but fortunately heart defibrillation is able to restore a sinus rhythm. After several days in the hospital Mark is able to return home.

Question 3: What causes ventricular fibrillation and why is it so dangerous? How does heart defibrillation restore normal heart rhythm?

Question 4: Draw and ECG that would represent what was going on in Mark’s heart during ventricular fibrillation.

4: Sally a 35 year old sky diver goes to the doctor complaining of periods of light headiness and a slower than normal pulse. During a stress test the doctor notices some abnormalities with her ECG. The doctor tells Sally she has a 2:1 AV nodal block.

Question 1: What is the function of the AV node in the heart, and where on an ECG is the activity of the AV node seen?

Question 2: What abnormalities would a 2:1 AV nodal block cause on an ECG? What does 2:1 mean? Why is her pulse rate slowed? What is the name given to a slower than normal heart rate?

Question 3: Draw an ECG representing what is happening in Sally’s heart.

After consulting with Sally the doctor decides that an internal pacemaker is probably the best treatment for her condition. The procedure is scheduled for next month.

Question 4: Why is the doctor suggesting implanting a pacemaker? How will this help Sally’s condition?