CARDIOVASCULAR SYSTEM SGD CASE
A blood clot is also called
H.I, a 60-year-old male office worker was
admitted in the emergency room due to
complaints of severe chest pain while at
work. The pain was relieved by taking
nitroglycerin and thrombolytics. The patient
also complained of easy fatigability and
inability to perform heavy tasks at home and
at work. 3 weeks ago, patient experienced
chest pain after doing moderate heavy
chores while at home. This occurred 3 times
and was relieved by rest. Patient also
experienced shortness of breath when
climbing stairs or walking long distances.
Patient has been taking maintenance
medication for hypertension. The patient was
diagnosed with myocardial ischemia
secondary to coronary artery disease.
SAMPLE GUIDE QUESTIONS
1. What specific parts of the circulatory
system is affected in this case?
 Myocardium – Myocardial ischemia
occurs when blood flow to myocardium
is obstructed by a partial or complete
blockage of a coronary artery by a
buildup of plaques.
 Arteries (blood vessel) – The arteries
carry oxygen and nutrients away from
your heart, to your body's tissues.
 Coronary arteries - provide the main
blood supply to the heart. The coronary
arteries also supply the myocardium
with oxygen to allow for the contraction
of the heart and thus causing
circulation of the blood throughout the
body.
2. What are the normal functions of the
body system involved in this case?
 Blood circulation – pumps blood from
the heart to the lungs to get oxygen.
The heart then sends oxygenated blood
through arteries to the rest of the body.
 Blood clotting – Clotting is a normal
function that stops your body from
bleeding too much when you get hurt.
Normally, a blood clots start as a
response to injury of a blood vessel.
When a blood clot forms where it
should not have developed, it is called
a thrombus.
a thrombus.
3. Discuss the specific structure involved
as to:
a. The structure / anatomy
 Coronary arteries – The coronary
arteries run along the coronary
sulcus of the myocardium of the
heart. They start at the aortic root,
which is the first part of your aorta
that emerges from the left ventricle
of your heart.
 Myocardium – It makes up the
middle and thickest layer of the
heart wall.
b. The function / physiology
 Coronary arteries – The right and
left coronary arteries supply blood
to your heart. 
 Myocardium – It contracts and
releases involuntarily that is
responsible for keeping the heart
pumping blood around the body.
4. What are the risk factors / causes of the
medical condition?
Factors that can increase your risk of
developing myocardial ischemia include:
 Smoking and long-term exposure to
secondhand smoke can damage the
inside walls of arteries. The damage
can allow deposits of cholesterol and
other substances to collect and slow
blood flow in the coronary arteries.
Smoking causes the coronary arteries
to spasm and may also increase the
risk of blood clots.
 Diabetes and high blood pressure.
Over time, high blood pressure can
accelerate atherosclerosis, resulting in
damage to the coronary arteries.
  High blood cholesterol level.
Cholesterol is a major part of the
deposits that can narrow your coronary
arteries.
 Obesity is associated with diabetes,
high blood pressure and high blood
cholesterol levels.
 Lack of physical activity. Not getting
enough exercise contributes to obesity
and is linked to higher cholesterol.
5. What are the ways to prevent these risk
factors/ causes?
 Avoid inhaling secondhand smoke to
protect yourself, or quit smoking while
it’s still early to prevent future difficult
health conditions.
 Balance the food you consume and eat
fiber-rich foods to promote weight loss
and lower the risk of diabetes such as:
o Fruits, such as tomatoes, peppers
and fruit from trees
o Nonstarchy vegetables, such as
leafy greens, broccoli and
cauliflower
 Get and practice regular aerobic
exercises to have better heart health,
which is associated with a lower risk of
myocardial ischemia and heart attack.
Exercise also reduces blood pressure.
6. What is the effect of aging in the body
system involved?
 Hypertension – High blood pressure is
a common condition that affects the
body's arteries. If you have high blood
pressure, the force of the blood pushing
against the artery walls is consistently
too high. The heart has to work harder
to pump blood.
o Aging is a continual and
progressive process that results in
decreased physiologic function
across all organ systems.
o Several studies indicated that the
incidence of arterial stiffness and
hypertension is higher in the aged.
o Cardiovascular aging is an
important factor that determines life
span. The wall of large arteries,
especially aorta, thicken and lose
elasticity over time, and this
process results in an increase in
pulse wave velocity, an important
and reliable measure of arterial
stiffness. The increased arterial
stiffness, whatever its underlying
causes, would reduce the
function of the arteries near the
heart and increase pulse wave
velocity, both of which increase
systolic and pulse pressure.
o
7. What are the approaches done by a
professional Medical Laboratory
Scientist in this case?
 Medical laboratory scientists perform
mostly of the laboratory tests to identify
and examine specific signs of
hypertension that can eventually lead to
myocardial ischemia. Blood and urine
tests are done to check for conditions
that can cause or worsen high blood
pressure. For example, tests are done
to check your cholesterol and blood
sugar levels. You may also have lab
tests to check your kidney, liver and
thyroid function.
o Routine lab tests are
recommended before beginning
treatment of high blood pressure to
determine organ or tissue damage
or other risk factors. These lab
tests include urinalysis, blood cell
count, blood chemistry (potassium,
sodium, creatinine, fasting glucose,
total cholesterol and HDL
cholesterol), and an ECG
(electrocardiogram).
o Electrocardiogram – a simple test
that can be used to check your
heart's rhythm and electrical
activity. Sensors attached to the
skin are used to detect the
electrical signals produced by your
heart each time it beats.
o A blood pressure test measures
the pressure in the arteries as the
heart pumps. A blood pressure test
may be done as a part of a routine
health checkup or as a screening
for high blood pressure
(hypertension).
8. As a future MLS, what advise/s will you
give to enhance and maintain the health
of the body system involved in the case?
  Alagaan niyo sarili niyo mga
bwakanangshet saken niyo pa iaaasa
problema niyo
 Do not underestimate or ignore the
symptoms and signs your body is
experiencing. It is highly suggested to
manage underlying health conditions to
prevent worst case scenarios. Treat
diseases or conditions that can
increase your risk of myocardial
ischemia, such as diabetes, high blood
pressure and high blood cholesterol.
 Practice healthy techniques for
managing stress, such as muscle
relaxation and deep breathing, instead
of endangering your health in smoking
and other life-threatening ways.
ADDITIONAL INFORMATION
Myocardial Ischemia (ischemia: to suppress
blood) – also called cardiac ischemia, reduces
the heart muscle's ability to pump blood.
Myocardial ischemia occurs when the blood
flow through one or more of your coronary
arteries is decreased. The low blood flow
decreases the amount of oxygen your heart
muscle receives. Myocardial ischemia might
also cause serious abnormal heart rhythms.
Hypertension – High blood pressure can
damage your arteries by making them less
elastic, which decreases the flow of blood and
oxygen to your heart and leads to heart
disease. In addition, decreased blood flow to
the heart can cause: Chest pain, also called
angina.
Nitroglycerin – Used to prevent angina (chest
pain) caused by coronary artery disease. This
medicine is also used to relieve an angina
attack that is already occurring. It works by
relaxing the blood vessels and increasing the
supply of blood and oxygen to the heart while
reducing its work load. It belongs to a class of
drugs called vasodilators.
Vasodilators – are medications that open
(dilate) blood vessels. They affect the
muscles in the walls of the arteries and
veins, preventing the muscles from
tightening and the walls from narrowing. As
a result, blood flows more easily through the
vessels.
Thrombolytics – work by dissolving dangerous
clots in blood vessels. This helps restart blood
flow to the heart and helps prevent damage to
the heart muscle.
Blood Clot – are gel-like collections of blood
that form in your veins or arteries when blood
changes from liquid to partially solid. Clotting is
normal, but clots can be dangerous when they
do not dissolve on their own.
Coronary artery disease – caused by plaque
buildup in the walls of the arteries that supply
blood to the heart (called coronary arteries) and
other parts of the body. Narrowed arteries can
cause chest pain because they can block blood
flow to your heart muscle and the rest of your
body.
Plaque – made up of deposits of cholesterol
and other substances in the artery. Plaque
buildup causes the inside of the arteries to
narrow over time, which can partially or totally
block the blood flow. This process is called
atherosclerosis. When plaque that forms in
your narrow coronary artery breaks apart, it can
attract a blood clot. When a blood clot settles
in a coronary artery that’s already narrow, it
can cause a blockage (thrombosis).