1) A 14-year-old girl undergoing a physical examination prior to being admitted to summer camp was found to have a loud diastolic murmur at the second intercostal space to the left side of the sternum. Explain the reason for the loud heart murmur associated with this girl's condition.
2) A man enters the hospital complaining of chest pain. His history includes smoking, a stressful job, a diet heavy in saturated fats, lack of exercise, and high blood pressure. Although he is not suffering from a heart attack, his doctor explains to him that a heart attack is quite possible. What did the chest pain indicate? Why is this man a prime candidate for a heart attack?
3) An older woman complains of shortness of breath and intermittent fainting spells. Her doctor runs various tests and finds that the atrioventricular (AV) node is not functioning properly. What is the suggested treatment?
4) A Doppler ultrasound was performed on an infant who had symptoms of breathlessness and it was found that he had a patent ductus arteriosus. Discuss the location and function of the ductus arteriosus in the fetus and relate it to the reason for the infant's breathlessness.
5) A patient takes a nitroglycerin tablet sublingually for chest pain. Nitroglycerin acts directly on smooth muscle, producing relaxation and vessel dilation. How would this relieve chest pain?
6) A patient was admitted to the hospital with chest pains. On admission, his pulse was 110 and blood pressure was 96/64. According to his history, his normal pulse rate is usually between 80 and 88 and his blood pressure runs from 120/70 to 130/80. Explain why these changes in BP and HR occur.
7) A 55-year-old male was admitted to the hospital with heart failure. He complains of increasing shortness of breath on exertion and needing to sleep on three pillows at night. On physical assessment, the nurse determines that his ankles and feet are very swollen. Which of these symptoms reflect left-sided heart failure and which reflect right-sided heart failure?
8) Asystole is the total absence of ventricular electrical activity. Explain why defibrillation would not be effective in this situation.
9) A patient is prescribed a calcium channel blocker to prevent angina (chest pain), by decreasing the demand for oxygen. Explain why.
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