Cardiac Concept/Patho Map

W.S. is a 51-year-old man, who was assisting in launching his best friend's water ski boat from a boat trailer when he began to experience chest discomfort.  At first he believed his discomfort was because of the extreme July heat.  Gradually, this discomfort became a crushing pain in his sternal area that radiated into his left arm and lower jaw.  His friend suspected he was having a heart attack and convinced W.S. to go to the emergency department.  During the drive down a canyon with steep, winding curves, W.S. collapsed.

Upon arrival to the emergency department, W.S. was unconscious.  His skin was cool, clammy and very pale.  His blood pressure was so low that it had to be palpated, and his pulse was weak and irregular.  Electrocardiogram revealed a significant number of premature ventricular contractions.  Established resuscitation procedures were followed.  After his return to consciousness, an electrocardiogram showed evidence of anterior myocardial injury, and blood was drawn to check enzyme and electrolyte levels.  When a history could be obtained, W.S. stated that he was a harassed advertising executive and he was being treated for hypertension.  He acknowledged smoking three packs of cigarettes a day for 30 years.  His father died of a heart attack at the age of 47, and his mother had type II diabetes.

The physician also ordered an echocardiogram which revealed an enlarged heart and the beginning congestive heart failure.

Note: In your concept/patho map be sure to be detailed in relation to the pathophysiological changes and the interrelationship between the systems involved in maintaining the patient's hemodynamic status.