What immediate interventions should be initiated

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Assignment

Case Study

Patient Presentation

Mr. James R., a 62-year-old male, presents to the emergency department with complaints of chest pain that began at rest while watching TV. He describes the pain as "squeezing and heavy," radiating to his left arm and jaw. He rates the pain as 8/10. The pain started about 40 minutes ago and has not improved after taking two sublingual nitroglycerin tablets at home.

I. Medical History

i. Hypertension (10 years)
ii. Hyperlipidemia
iii. Smokes 1 pack/day for 25 years
iv. Overweight (BMI: 31)
v. Father died of a heart attack at age 59

II. Vital Signs on Admission

i. Blood Pressure: 92/58 mmHg
ii. Heart Rate: 110 bpm, irregular
iii. Respiratory Rate: 24/min
iv. Temperature: 98.6°F (37°C)
v. O2 Saturation: 89% on room air

III. Physical Examination

i. Patient is diaphoretic and anxious
ii. Auscultation: S4 heart sound, occasional premature ventricular contractions (PVCs)
iii. Lungs: Crackles in the lower bases bilaterally
iv. Jugular venous distension noted

IV. Diagnostics

i. ECG: ST-segment elevation in leads II, III, aVF (inferior MI)
ii. Troponin I: Elevated at 2.8 ng/mL (normal < 0.04)
iii. BNP: Elevated
iv. Chest X-ray: Pulmonary congestion, cardiomegaly

Task

I. What condition is most likely based on Mr. James R.'s presentation and diagnostics?

II. What immediate interventions should be initiated? Get the instant assignment help.

III. What are two major complications Mr. James R. is at risk for post-MI?

IV. What lifestyle modifications should be emphasized for secondary prevention?

Reference no: EM133944840

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