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When Shirley Archibald was 16 years old, she started smoking. She picked up the bad habit from her best friend, Johanna. Shirley used to be a track star, but when she became addicted to smoking, she had to quit the track team because her lungs couldn’t handle it. Shirley rarely exercises now. She is presently 42 years old and she has been having chest pains for the past month. She made an appointment with her usual doctor to have the pains looked at. She went to her doctor’s appointment and described the pain she was having and the doctor said that she would need to have tests done to make sure it wasn’t anything serious. She was scheduled for a chest x-ray, an electrocardiogram, and a blood test. Shirley went through all of the tests and then she was asked about her family history. She told her doctor that her grandma had coronary heart disease. The doctor told her that the disease can sometimes be hereditary. The test results came back positive for coronary heart disease. The doctor explained to Shirley that coronary heart disease is when your coronary arteries (the arteries that supply your heart muscle with oxygenated blood) become narrow due to a gradual build-up of fatty material within their walls. This may be caused by genetics, smoking, poor diet, high cholesterol, and lack of exercise.
The coronary artery's main purpose is to supply blood to the heart muscle.
I used this picture to explain how the cardiovascular system works and I circled the area of the coronary artery.
I used this picture to show what a chest x-ray machine would see.
I used this picture to show where the coronary artery is in the herat.
Shirley went to the doctor because she was having a sharp pain in her chest for about a month. She booked an appointment with her doctor. Depending on her doctor finding a good appointment time could take anywhere from a week to a month. Then she will have a 30 minute consultation to ask any questions or concerns that she might have. The doctor will ask if her family has a history of heart problems. Then she will have to come back in approximately a week for her full physical exam. The doctor might suspect coronary heart disease (CHD). If the doctor diagnoses this Shirley will have to be put through a series of tests The first one will most likely be a chest x-ray, for this you will have to stand in front of the x-ray machine and you will have to hold your breath. Two images are usually taken one when you are facing the machine and the other one standing sideways. They do this so they can get a good image of your heart. This test rules out multiple lung problems because in this scan they were looking for heart problems . They ruled out all vertebrae and rib injuries. They may also use an EKG (electrocardiogram). They place electrodes on both arms, both legs, and your chest. They then hook those to a machine that will trace your heart activity onto paper. You will have to lie on a table or bed and breathe normally. You maybe be asked to hold your breath at certain times. You cannot talk during this test. It will take 5 to 10 minutes. They use this to investigate and pin point the location of the patients pain. Shirley will then have to get blood tests done. The doctor will have to send these to the lab. To get your results it will take a minimum of 24 hours they will call you when the result are in. They use this to count your “bad cholesterol" (LDL) in your blood. They will use an x-ray machine, EKG machine, a needle, and blood testing machines in the lab. The biggest part of the diagnosis was the pain Shirley felt in her chest this lead the doctors to looking for heart problems.
I used this picture to show what the coronary artery looks like before and after the build up of fatty material.
The doctor recommended a PCI (Percutaneous Coronary Intervention). This is a non-surgical procedure. This procedure was chosen because it is safer then others. It has a 97.3% rate. The PCI can last from 30 minutes to 2 hours, but it usually last 1 hour. They will put the catheter in her arm. During the procedure Shirley might feel some slight chest pain, nausea, and/ or a headache. These will only last for a few minutes (The full surgery will be explained in the video). After the procedure Shirley will be taken to a monitored bed for observation. The catheter will be taken out 4 to 12 hours after she get to the bed. After they take the catheter out the area where the catheter will need to be compressed for about 20 minutes to stop the bleeding. Shirley will be allowed to leave after about a day after the procedure. Shirley will not be allowed to lift anything over 20 pounds or do exertion for the next one or two weeks. Shirley will then have to go in a 12 week rehabilitation program. She will have to do stress testing once a week to make sure her heart is still healthy. She will have to stop smoking so the problem does not reoccur again. She will have to change her eating habits so she eats less fats. She will have to exercise one hour three times a week. She might even workout more to reduce her weight. She will also be given counsellors to help her change her lifestyle.
I used this video to show what the surgery would look like.