One of the possible complications associated with orthopedic surgery, especially joint surgery, is chronic diseases’ aggravation. Also, a relatively common complication after total knee replacement is thromboembolism, the symptoms of which are sudden difficulty breathing and sudden chest pains, aggravated by deep breathing and coughing. At the time of admission, the reported symptoms indicate the possibility of thromboembolism, as well as heart failure. At the same time, as Inamdar and Inamdar (2016) state, heart failure “has primarily been recognized as a disease of the elderly population (> 60 years) and is reported to affect about 2-3% of people in the United States” (p. 65). Thus, it is necessary to conduct a series of medical studies to determine the cause of the patient’s poor health. Presented case-study reports that doctors performed EKG, which revealed new onset atrial fibrillation and right ventricular strain pattern – T wave inversions in the right precordial leads (V1-4)+- the inferior leads (II, III, aVF). These symptoms are “associated with increased pulmonary artery pressures in the setting of acute or chronic right ventricular hypertrophy or dilatation” (Burns & Buttner, para. 7). The most common diseases and pathologies related to these processes are pulmonary hypertension, mitral stenosis, pulmonary embolism, chronic lung disease, congenital heart disease, and arrhythmogenic right ventricular dysplasia (Burns & Buttner).
Race and health studies in the United States show many differences in health status between different racial and ethnic groups. All racial groups recognized by the census have different outcomes in terms of mental and physical health, but these differences are associated with different historical and current factors, including genetics, socioeconomic factors, and racism (Churchwell et al., 2020). Some diseases are more common among certain racial groups, and life expectancy also varies from group to group. Studies have examined the effect of confronting racism and discrimination on physiological performance in terms of cardiovascular and cardiopulmonary diseases. Although the relationship between racism and health is unclear and the results are conflicting, three likely cardiovascular damage mechanisms have been identified. Institutional racism leads to limited socioeconomic mobility opportunities, differential access to goods and resources, and poor living conditions (Williams & Ovbiagele, 2020). Personal experience of racism acts as a stress factor and can cause psychophysiological reactions that negatively affect the cardiovascular system’s health (Williams & Ovbiagele, 2020). Negative self-esteem and acceptance of negative cultural stereotypes as true (internalized racism) can harm cardiovascular health (Franco & O’Brien, 2020). According to the US Department of Health and Human Services Minority Health Administration, African Americans were 30% more likely to die of heart disease in 2018 than non-Hispanic whites (Williams & Ovbiagele, 2020). This health problem among African Americans has led to a host of other illnesses.
With age, the heart in humans slightly increases in size, its walls thicken, and the chambers’ volume slightly increases. Age-related loss of elasticity in the walls of the heart means that the left ventricle is not entirely filled with blood, which can sometimes lead to heart failure (called diastolic heart failure or conserved heart failure), especially in older people with other conditions. such as high blood pressure, obesity, and diabetes (McCance & Huether, 2018). The walls of the arteries and arterioles become thicker, and the space inside the arteries expands. Elastic fibers are lost in the walls of arteries and arterioles. Taken together, these changes make the vessels more rigid and less elastic. Because the arteries and arterioles are less elastic, blood pressure cannot quickly redistribute when standing up, so when standing up abruptly, older adults are at risk of dizziness or, in some cases, fainting. Since the arteries and arterioles become less elastic with age, they cannot relax as quickly during the heart’s rhythmic contractions (McCance & Huether, 2018). As a result, blood pressure during the heart’s contraction (during systole) increases by a greater amount than in younger people – and often goes beyond the normal range.
References
Burns, E., & Buttner, R. (2021). Right, Ventricular Strain. Life in the Fast Lane. LITFL. Web.
Churchwell, K., Elkind, M. S., Benjamin, R. M., Carson, A. P., Chang, E. K., Lawrence, W.,… & American Heart Association. (2020). Call to action: structural racism as a fundamental driver of health disparities: a presidential advisory from the American Heart Association. Circulation, 142(24), e454-e468.
Franco, M., & O’Brien, K. M. (2020). Taking Racism to Heart: Race‐Related Stressors and Cardiovascular Reactivity for Multiracial People. Journal of Multicultural Counseling and Development, 48(2), 83-94.
Inamdar, A. A., & Inamdar, A. C. (2016). Heart failure: diagnosis, management and utilization. Journal of clinical medicine, 5(7), 62.
McCance, K.L. & Huether, S.E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
Williams, O., & Ovbiagele, B. (2020). Stroking out while black—the complex role of racism. JAMA neurology, 77(11), 1343-1344.