Crimes of the Heart: A Case Study on Cardiac Anatomy
Tiffaney
is worried about her newborn son. Ever since she brought Caleb home
from the hospital it has been so hard to get him to eat and he seems to
be breathing too hard all the time. She stopped breast-feeding and tried
every bottle and formula on the market, but nothing has worked. So, at
his one-month check-up, her stomach is in knots as they place Caleb on
the scale. The nurse says, “9 pounds, 7 ounces.” Tiffaney realizes Caleb
has only gained one pound since he was born, and she breaks into tears.
Dr.
Baker checks over Caleb in the exam room, taking extra time feeling and
listening to his chest. During the exam, Tiffaney explains her struggle
with trying to get her son to eat and how he cries almost the entire
day. After the exam Dr. Baker says, “When I listen to Caleb’s heart, I
hear an extra sound called a murmur. I want to use an echocardiogram and
an ECG to get a good picture of all the parts of his heart.”
After
a full day of tests, Tiffaney meets with Dr. Baker in his office. He
explains, “After a careful review of all the information, I have
discovered that Caleb has a hole in the heart muscle wall between his
right and left ventricles. We call it a ventricular septal defect. That
is probably why he has been so irritable and hard to feed. The hole is
not very big, but he will still need to have surgery to repair it.”
Although the thought of her tiny son having surgery is terrifying,
Tiffaney is relieved to know why things have been so tough at home.
In your discussion post, you should include:
a) Main discussion paragraph (one or two paragraphs) and
b) Reply to at least TWO of your classmates.
Important points to include in your Main discussion post.
Paragraph 1
Caleb has abnormal heart sounds that tipped the doctor off to a problem.
Name the normal sounds of the heart and indicate what causes these sounds.
In relation to the normal heart sounds, when would you expect to hear the abnormal sound Dr. Baker heard? Explain your answer.
Paragraph 2
Background.
Set the scene: background information, relevant facts, and the most
important issues. … (What made Tiffaney suspect that there was
something wrong with her infant?)
Evaluation
of the Case. Outline the various pieces of the case study that you are
focusing on. … (How did Dr. Baker proceed with her examination and
what were her conclusions?
____________________________________________________________
Reply to TWO of your classmates
– Your reply should include (Proposed Solution/Changes/recommendations.
… (What did Dr. Baker suggest? What are the benefits/risks of the
proposed heart surgery on an infant (exchange ideas/thoughts with TWO your classmates)
Respond to the following classmate post (1): Typically,
the heart generates two discernible sounds. Known as “lub-dub,” these
normal sounds accompany each heartbeat. The initial “lub” sound arises
from the closure of the mitral and tricuspid valves at the onset of
systole, while the subsequent “dub” sound is attributed to the closure
of the aortic and pulmonary valves at the conclusion of systole. These
acoustic signals serve as critical markers of robust cardiac function,
demonstrating the systematic circulation of blood within the heart. In
Caleb’s case, Dr. Baker identified an anomalous sound referred to as a
murmur during his examination. Murmurs arise from turbulent blood flow
within the heart’s chambers or valves. Dr. Baker detected this murmur
just after S1 and preceding S2, as blood traversed the ventricular
septal defect (VSD), producing distinctive acoustic qualities that
warranted additional investigation through echocardiography and
electrocardiography (ECG). Tiffany’s concerns surfaced shortly after
she returned home from the hospital and began caring for her newborn.
Observing her baby closely, she noticed signs such as feeding
difficulties, excessive irritability, and respiratory distress. In the
lead-up to Caleb’s one-month checkup, Tiffany diligently experimented
with different feeding methods, including discontinuing breastfeeding,
trying various bottles, and testing different baby formulas, hoping to
identify the cause of Caleb’s persistent symptoms. Despite these
efforts, Caleb’s condition remained unchanged, prompting Tiffany to seek
medical advice.During Caleb’s one-month checkup, his slow weight gain
caught Dr. Baker’s attention. Dr. Baker conducted a thorough examination
of Caleb’s chest and detected a murmur through careful auscultation
with a stethoscope. Concerned by this finding, Dr. Baker ordered both an
echocardiogram and an electrocardiogram (ECG) to further investigate
Caleb’s condition. Dr. Baker proceeded with an
echocardiogram and an ECG to conduct a comprehensive evaluation of
Caleb’s cardiac structure and function. These diagnostic tests confirmed
the presence of a ventricular septal defect (VSD), characterized by a
small hole between Caleb’s heart ventricles. Dr. Baker’s recommendation
for surgical intervention underscores the gravity of Caleb’s condition.
Despite the VSD’s small size, surgery is deemed necessary to mitigate
potential complications such as heart failure and to optimize Caleb’s
feeding tolerance and overall health.
Respond to the following classmate post (2): Caleb’s abnormal heart sounds tipped off Dr. Baker to a problem.
Normally, the heart makes two sounds, “lub-dub.” The first sound, “lub,”
happens when the heart valves close as the heart pumps blood out. The
second sound, “dub,” happens when different valves close as the heart
relaxes. Dr. Baker heard an extra sound called a murmur, which is caused
by blood flowing abnormally through the heart, likely due to a hole
between the heart’s right and left sides.
Tiffaney noticed something was wrong with Caleb because he had
trouble eating and cried a lot. At his one-month check-up, he had barely
gained any weight. Dr. Baker listened to Caleb’s heart and heard a
murmur, prompting further tests like an echocardiogram and an ECG. These
tests showed that Caleb had a ventricular septal defect, a small hole
in the heart wall. Dr. Baker explained that while the hole wasn’t big,
it was causing Caleb’s issues and would need to be repaired with
surgery. Tiffaney felt scared about the surgery but relieved to know
what was wrong.
