Question: Alterations In Cardiovascular Function Source: Copstead, L. & Banasik, J. (2006). Pathophysiology (3rd Ed.). Mosby. A.O. Was An 89-year-old Woman With A Long History Of Heart Failure Secondary To A Large Left Ventricular Infarct. She Had Poor Activity Tolerance And Required Assistance With Activities Of Daily Living. Even Minimal Activity Was Associated …

Alterations in Cardiovascular Function

Source: Copstead, L. & Banasik, J. (2006).Pathophysiology (3rd ed.). Mosby.

A.O. was an 89-year-old woman with a long history of heartfailure secondary to a large left ventricular infarct. She had pooractivity tolerance and required assistance with activities of dailyliving. Even minimal activity was associated with moderately severedyspnea and exertional chest pain, which was relieved by rest. A.O.also exhibited marked pedal edema bilaterally. She took digitalis,furosemide (Lasix), KCl, and sublingual nitroglycerin.

Case Questions

1. Which type of heart failure(left or right sided) is usually associated with dyspnea? Whatother clinical findings are likely to be present with this type ofheart failure?
2. What compensatory mechanismsare likely to be operative in A.O. to enhance cardiac output?
3. What is the most likely causeof A.O.’s pedal edema?
4. What is the cause of A.O.’sexertional chest pain? What laboratory tests would be useful toconfirm this diagnosis?
5. What is the rationale for theuse of each of A.O.’s medications in managing her heartdisease?