Pathophysiological changes of heart failure, hazards of oxygen theropy in patient with heart failure.
In relation to the data below Relate the signs and symptoms of the patient below to their underlying pathophysiological changes of heart failure. Explain the possible hazards of oxygen therapy in this patient.
60 year old male, had an myocardial infarction several years ago.
Bilateral leg oedema up to his calf and shortness of breath on exercise.
Has a heart rate of 100 beats per minute, and arterial blood pressure of 100/60 mmHg. Patient has an inlarged heart.
Arterial blood sample of patient:
Pco2 = 7.2 kPa (4.8 - 6.1)
P02 = 7.0 kPa (10.0 - 13.3 )
Ph = 7.29 (7.36 - 7.44)
Exhocardiography revealed severe left ventricular dysfunction with an ejection fraction of 32%. Coronary angiography showed complete occlusion of the right coronary artery 40mm distal to its origin, and diffuse, non occlusive disease in the major branches of the left artery.
Patient family history: both parents died at around 60 years of age. Two brothers who are smokers have been admitted to hospital for cardiac problems.
Patient has been smoking 30 cigarettes a day since he was 17 .
Patient has been suffering from from angina pain on mild exertion and been radiating down left arm even at rest. Need to sleep at night with raised pillows but wakes up due to feeling breathless.