case study concerning cardiovascular and respiratory disease processes
Thank you for your participation in this week’s case study concerning cardiovascular and respiratory disease processes. The case study assigned to you dealt with the identification of cardiovascular anomalies within the pediatric group. The patient in the case study has some concerning findings regarding the physical examination, which shows that the patient has a result of a grade III/IV systolic ejection murmur linked with HPI of reduced feeding at night but without weight decline.
Although the appearance of murmurs in infants can be a common incident. Not to mention, most pediatric murmurs are harmless and have no significant adverse effect on the functionality of the cardiovascular system (Etoom & Ratnapalan, 2014). Additionally, the group of patients with grade II murmurs overall condition of life often have no negative influence on health, and in many cases, the presence of the murmur goes as the child grows older without leaving any long-term issues (Sackey, 2016)
However, the patient in case study 6 has a higher graded murmur based on the Levine grading scale that applies loudness and intensity to determine the severity of the murmur. The truth is that murmur is a grade III/IV systolic ejection and can lead to structural deformities. Such uncertainty includes ventricular septal defect, persistent patency of the arterial duct (ductus arteriosus), and atrioventricular valve regurgitation (Sackey, 2016). These conditions, if left untreated, will negatively affect the patient’s and parents’ quality of life, growth patterns could prove to be fatal and increase the risk for myocardial infarction and cerebral vascular accidents (Sackey, 2016).
The patient in the case study should be introduced for further diagnostic testing in a particular chest x-ray to get a baseline image of the heart and lungs, EKG to get baseline cardiac rhythm and echocardiogram to view the overall structure of the heart. Additionally, the diagnostic testing PMH should be taken concerning the events of the pregnancy, family history of heart or pulmonary disease as well as endocrine dysfunctions (thyroid disease can cause cardiac anomalies) (Etoom & Ratnapalan, 2014).
Lastly, the patient should be referred for a consultation with a pediatric cardiologist for further evaluation and warranted appropriate management in the form of preventive care. Regarding cultural and social-economic barriers, I agree with our peer that additional information is needed to determine the patient’s parent’s needs concerning possible language barriers. This can be taken into consideration where English is not their primary language, as well as the provider being cognitive about cultural customs and rituals. Again, thank you for participating in your opinions and perspective on this case study, which is very enlightening.
Reference
Etoom, Y., & Ratnapalan, S. (2014). Evaluation of Children with Heart Murmurs. Clinical
Pediatrics, 53(2), 111–117. https://doi.org/10.1177/0009922813488653
Sackey, A. H. (2016). Prevalence and diagnostic accuracy of heart disease in children with
asymptomatic murmurs. Cardiology in the Young, 26(3), 446–450. https://doi-org.ezp.waldenulibrary.org/10.1017/S1047951115000396