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Thursday 15 October 2015

A Case Study on Heart Skips


Arrhythmia Statistics
            Based on the statistics by the American Heart Association, there are 4 300 000 Americans that are diagnosed with Arrhythmia and 630 000 of them are admitted annually. The most common kind of Arrhythmia is the Atrial Fibrillation, where 2.2 million Americans are diagnosed with that disease. 70% of people having Atrial Fibrillation are between the ages of 65 to 85. Per year, there are more than 250 000 deaths per year caused by Ventricular Fibrillation. 
Case Study
            This case study is about Roger, who is 58 years old and he had Atrial Fibrillation. Atrial Fibrillation is a type of fast heart beat arrhythmia (Tachycardia). It is the most common type of arrhythmia and it is when your heart does not pump regularly or work as properly as it should. This causes a “fluttering” heart beat, irregular pulse and in Roger’s case, having severe chest pains. He felt a lot of nerve activity in his chest area. At first, the pain was only temporarily but as time goes by, the symptoms increased and lasted longer. After five months, he could not take the pain and decided to see his general practioner. His GP’s first reaction was he taught that Roger is having a problem. Roger was taken aback as his family has no history of any heart problem or diseases related to the heart. His first question was, “how could that even be?”. His GP then recommended him to make an appointment with a heart specialist at a hospital.
            Within the next eight weeks, he met a heart specialist. Roger then proceeded by showing all his medical records and check-ups with is GP.  The heart specialist first reaction is that his heart problem could be related to a heart rhythm disturbance.
            By the following month, he had two Electrocardiograms (ECG), Echocardiogram, and a seven-day event recorder. After the next meeting with the heat specialist, it is then confirmed that Roger is having Arrhythmia and it is due to Paroxysmal Atrial Fibrillation. Paroxysmal Atrial Fibrillation is when electrical signals in an individual’s heart causes the heart to beat rapidly and it just stop on its own (Case-Lo, 2013). At first, the heart specialist prescribed medication to lower his blood pressure but it did have very little positive effects on him. He was then given anti-arrhythmic medication and beta-blockers. He felt good for the first ten days as he did not experience any symptoms. Sadly, these medication made Roger feel very tired and was unable to perform his daily activities and his job. Besides that, he kept a diary to jot down he felt every day since the change of medication. It was also to track his Atrial Fibrillation episodes over the months and tried various medication of the different dosage. Although with all the medication, he was still experiencing the symptoms even after meeting the heart specialist eight months later. So he got another medication and this time, he felt a lot of positive effect on him. It made a big and fast improvement in Roger. Again, the medicine was also effective for a short period of time and the symptoms kept coming back days after that. The heart specialist then asked him to refer to a hospital that has an Electrophysiological Cardiologist.
            An Electrophysiological Cardiologist are qualified to perform special tests on an individual’s heart electrical system (Orenstein, 2011). For an example, electrophysiology study or an ablation and these was what the Electrophysiological Cardiologist suggested Roger to go through. He explained that is has a 70% probability of being a success. Roger agreed and was ask to be on the waiting list for the procedure. His medication was changed to the previous anti arrhythmic medication hoping that the effects would last longer but he was still having symptoms and every day became a struggle for him.
            Roger received a letter from the hospital with the date arranged for him to undergo the procedure. A week before the date of the procedure, he was asked to be at the hospital for a pre-admission check-up and give a 45 minute information session about the procedure. A week later, he arrived to the hospital for a procedure called Pulmonary Vein Isolation. He was given medication to relax him and the procedure lasted for three hours.
            After the procedure, he was sent to a special care unit to recover for the first few hours after the procedure. His recovery was good and uncomplicated and the doctors allowed him to go back the next day. Roger had home rest for the first two weeks and still have to take his medication for the next eight weeks.
            Even years after the procedure, his symptoms decreased and he is much better now. He still takes his medicationn to control his high blood pressure but now he only goes to the hospital annually for a review after the procedure. His symptoms then completely subsided.

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