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Part I — The wake-up call It was 4:36 a.m. She was in a cold sweat and having difficulty breathing. She felt as though she had run a marathon. Fear swept through her—something terrible was going to happen. Panic-stricken, she woke her husband, Jeremy. "Denise, what is it? Is it a nightmare?" "No, it's like I'm having an asthma attack. I feel lightheaded and I can't catch my breath. My heart feels like it's beating a thousand times a minute." Afraid to upset her husband further, Denise didn't tell him that an immense feeling of apprehension suddenly overcame her. She got up to drink some water and waited for the anxiety to subside. Her mind was racing. Jeremy had a family history of heart disease. This couldn't be happening to her. It was his problem. A few months earlier Jeremy was diagnosed with coronary artery disease. He was only 48 years old, the same age as Denise. The scare had encouraged him to gradually end years of chain smoking and adopt a healthier lifestyle. He was currently working on giving up the occasional cigarette for good. "No," Denise thought to herself. "There's no way this was a sign of heart troubles. I didn't have a pain in my chest, I'm physically fit, and I have no family history. There's just no way." After assuring herself of this, Denise was somehow able to fall back asleep. The next day at work, Denise was having a hard time focusing. Maybe the stress of her job was finally catching up with her. Managing a catering business was not an easy task. On top of that, her only daughter, Emily, had left for college this year and, being the overprotective parent that she was, Denise found herself constantly worrying about how her daughter was faring in a different city, away from the comforts of home. Also, Denise was in perimenopause. The hormonal changes, combined with fatigue, stress, and her general worrisome nature, were catching up to her. Not only that, she couldn't get last night's scary episode out of her thoughts. Was it just part of the whole perimenopause thing or was it more? Her body was trying to tell her something, but Denise wasn't sure she was ready to hear.

 

Conversation by the heart… "I wonder if Denise realises how all those years of second-hand smoke have taken a toll on her lungs and on ME, her heart! All that tobacco inhalation has constricted her coronary arteries. Sure, Denise tries to stay physically active but genetics and her food choices have brought her blood cholesterol up pretty high to 6 mmol/L. She could be headed for heart disease. A person's total cholesterol level shouldn't get above 5.5 mmol/L. That's right. Geesh. Get with it, Denise. That was a major warning last night. I'm oxygen-starved! Luckily, only a small area of my left ventricle had a big decrease in blood flow and oxygen supply (cardiac ischaemia). Thank goodness. If nothing else happens, my body will start growing some new collateral vessels (bypass channels) and I can get some repair work done. Denise didn't experience chest pain (angina pectoris). But her rapid heartbeat and shortness of 4 breath sure got her attention. She had better shape up because I don't know if I can handle much more oxygen deprivation. And, hey, all this unstable plaque lurking around is not a good sign either. No indeed. Who knows when it may rupture? I don't like the looks of this at all." (NCCSTS case studies)

 

1. Draw a sketch of the heart and show where the coronary blood vessels lie.

2. List in order the blood vessels that a drop of blood would follow as it makes a complete journey around the body starting as it enters the right atrium until it returns to the right atrium.

 

 

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  • Posted on : June 01st, 2019

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