Cardiac Exercise Prescription, Referral & Rehabilitation case study Essay

Cardiac Exercise Prescription, Referral & Rehabilitation case study - Essay Example The pain typically lasts for 5 to 10 minutes and subsides with rest. The pain is non-radiating and is not associated with other symptoms like nausea, vomiting, cough, breathlessness, palpitations, syncopal attacks, expectoration, edema or fever. The patient also complains of easy fatiguibility since 15 days. Past Medical History (Non-cardiac): He has hypertension since 10 years and is on antihypertensives and aspirin. He has high blood cholesterol levels which has reduced after initiation of cholesterol lowering agents. Peter suffered from major illness at 20 years of age when more than half his lung was damaged due to pneumonia. He underwent 2 hernia operations, one for right inguinal hernia 10 years ago and a repeat surgery for the same hernia 6 years ago. His stay in the hospital during that period was uneventful. Peter does not have diabetes mellitus. There are no known allergies identified in him. Cardiac History: The patient is a known case of myocardial ischemia, diagnosed 4 y ears ago when he was treated with placement of stents. 17 months ago he suffered from myocardial ischemia. Currently, he is admitted for angina due to ischemic heart disease. Ischemic heart disease or IHD or coronary heart disease is a condition in which there is oxygen deprivation to the muscles of the heart as a result of decreased blood flow and perfusion and is accompanied by inadequate removal of the products of metabolism (Zevitz, 2006). This is the most common form of heart disease and a leading cause of premature death in the developed countries (Zevitz, 2006). The hallmark feature of this condition is imbalance between the supply and demand of oxygen of the myocardium which can occur either due to increased myocardial oxygen demand or decreased myocardial oxygen supply or both. Ischemia to the myocardium results from disease in the coronary arteries. The disease is most often due to formation of atheroma and its consequences like thrombosis. Of all the arteries in the body, coronary arteries are at increased risk of developing atheroma (Maseri et al, 1992). Personal history: As a lorry driver, Peter used to enjoy eating fatty food, especially take away Chinese foods. The patient has regular diet and sleep. His bowel and bladder habits are regular. The patient was a smoker and used to smoke about 60 cigarettes a day. 3 years ago, the number came down to 10 per day. He has given up smoking now for the past one month. He does not take alcohol. He is not addicted to illicit drugs. He leads an active life and walks about half an hour a day for 5-6 days a week, of which atleast 10 minutes is brisk walking. His hobbies are racing and gardening. Family history: Both his parents were diabetic and hypertensive. However, there is no family history of heart disease. Peter is married and has one daughter and five sons, who are source of some stress to him. Education: Peter did not undergo proper schooling. He studied in a technical school for 3 years. He started w orking as a lorry driver since the age of 15. He did not receive any education about cardiac disease. Patient mentioned that if he received any such education earlier, he would have cut down on smoking. Risk Factor Profile: Modifiable risk factors: 1.