Cardiology ( Paramedic )

Evaluate the case below and choose two (2) potential differential diagnoses
that relate to PARA2000 topic content.
The case study will provide you with an opportunity to discuss:
Key clinical signs of the case
Differential diagnoses and their rationales
The pathophysiology of those diagnoses
Current management practices
A critique on the evidence supporting the management practices

You are required to demonstrate a thorough understanding of the
pathophysiology and provide rationales for your diagnosis and interventions.
It is expected that you research the condition from both text books and current
literature. At least five journal articles are expected to be part of your literature
search (Less than 10 years old). The goal is to provide up to date evidence
based practice for the management of the patient’s condition.
Higher grades will be awarded for evidence of extensive use of literature and a
critical evaluation of the care provided for the patient.
2500 word limit

Case Scenario

Situation: You have been called to the office of a 57 year old woman, Lily, who
experienced an episode of syncope.
Background: The patient has a history of has been complaining of feeling
increasingly unwell for the last 24 hours with pain in her chest. She has been
bruising easily over the last 3 months with some weight loss and is currently
being investigated by her GP.

PMHx: Angina diagnosed 2 years ago, angioplasty (successful), HT,


Med’n: Atenolol, GTN spray, transderm-nitro patch, salbutamol inhaler,

symbicort inhaler, paracetamol, aspirin PRN

Allergies: Morphine

Comm. Diseases – Nil Known, up to date with vaccinations

Social Hx: Lives with partner

Family Hx: Father died of heart disease, mother died of breast cancer

Alcohol: Social

Smoking: stopped 10 years ago (30/day)
Assessment: When you arrive you find the patient looking distressed.

Vital signs: BP 90/60, PR 105, RR 28, SaO2 96%, T35.1°C,

Appearance: Pale, cool, clammy, distressed

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