Reference no: EM132620569

Case 1

A 66-year-old male complaining of chest pain is brought to the emergency room by ambulance. The pain began six hours ago and has become more severe over the past hour prompting him to call emergency services. He describes the pain as retro-sternal, pressure-like, and non-radiating. He had some mild dyspnea and nausea accompanying the pain. He has also noted intermittent palpitations since last evening.

He has a past medical history of hypertension (not currently under treatment) and tobacco use of one pack per day of cigarettes for the past 47 years. Vital signs on arrival to the emergency room show a blood pressure of 160/100 mmHg, a heart rate of 92 beats per minute, and a respiratory rate of 18 per minute. His physical exam is unremarkable. He reports no allergies and no medication use.

Both EKG and cardiac enzymes are pointing towards "anterolateral infarction". At hospital he got thrombolytic treatment. In the first 4-5 hours post-thrombolytic treatment his chest pain and other signs and symptoms were disappeared. However, two days after the onset of the chest pain he had a cardiac arrest and died. His cardiac pathology image is seen here:

1) What is MOST LIKELY event associated with this patient's chest pain? Support your answer with the risk factors from patient's history.

2) Describe the etiology behind the cell injury that was happened in patients' myocyte?

3) What kind of cell injury is observed in the above picture? Was it reversible or irreversible? Explain your observation

4) According to Selye which stage(s) did he go through prior to ER visit?

5) This patient died despite the proper treatment. Explain your supporting pathophysiological arguments behind his cardiac arrest.

Could you guys help me with these please?