Cardiovascular Case Study
Mr. Jones has been complaining of right calf pain and tenderness since around 0900. He describes the pain as tight, “like someone is squeezing it” and reports he noticed that his sock was tight around his right leg when getting dressed this morning. He states that he came thru this exact ER three weeks ago when he was having heart trouble and needed surgery. He is currently on a maintenance dose of Coumadin for “irregular heartbeats” that had been diagnosed as intermittent atrial fibrillation three weeks ago, after mitral valve surgery. Mr. Jones says, “They warned me that if I didn’t take the Coumadin that I would be at risk for clots. I’ve been taking my medication exactly as prescribed, how could this happen?” He also asks that his “iron level” be checked because it was low after surgery. He says that he has been eating spinach at “nearly every meal” to improve his “iron.” Upon additional inquiry regarding his diet, you find out that he consumes one glass of grapefruit juice daily and is also taking garlic pills for his cholesterol. He says, “My wife wants me to be healthy, so she’s making me take all kinds of herbal medications.”
Mr. Jones’s right leg is edematous; his calf is reddened, warm, and tender to touch. His vital signs are T: 36.8 P: 98 and irregular R: 24 BP: 118/66.
Q1. What is the relationship between his atrial fibrillation and clot? What are the risks from this?
Answer: Atrial fibrillatio…
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