Human Virtual Patient Encounter – Cardiovascular Assessment

Human Virtual Patient Encounter – Cardiovascular Assessment

Diagnostic Tests and Cost Considerations

For this client, several diagnostic tests were selected to evaluate her cardiovascular condition. These include a 12-lead ECG, arterial blood gas (ABG), BNP test, cardiac nuclear stress test, complete blood count (CBC), echocardiogram (TTE), troponin I test, and CT pulmonary angiogram (CTPA) (Formiga et al., 2023). According to MDsave, based on their national average costs, the total for these tests would be around $5,500 to $7,000 if the client were without insurance. This major cost may affect my decision, and I may end up doing the most critical tests first. However, no insurance would alter my management plan since the tests are to be done for the diagnosis and treatment of presumed heart failure. Other alternatives that can help the client are financial assistance offered by hospitals or payment plans.

Community and Healthcare Support Services

Given the client’s condition, I would recommend several support services: heart failure education programs, cardiac rehabilitation, nutrition counseling, social work services for financial and emotional support, and home health care for medication management and symptom monitoring. Such services are offered in my community at local hospitals and community health centers. Referral is usually made upon submitting a request to the provider of the service in question, either through the care coordination department of the hospital or the patient’s primary care physician.

Clinical Judgment and Management

Diagnostic tests confirm the diagnosis of heart failure with preserved ejection fraction (HFpEF). The management plan would involve the alleviation of symptoms, increase in quality of life, and prevention of further cardiac status deterioration (Gard et al., 2020; Golla & Shams, 2024). It would be based on medication management, such as diuretics or ACE inhibitors, with lifestyle modifications, including sodium restriction and regular exercise. It will also involve close monitoring of symptoms and vitals.

In this direction, regular follow-up visits would be of the essence in fine-tuning the treatment plan and rendering continued support. Treatment of underlying diseases that may have precipitated heart failure—such as hypertension and diabetes—would also necessarily form an integral part of the holistic treatment plan.

References

Formiga, F., Nuñez, J., Moraga, M. J. C., Marcos, M. C., Egocheaga, M. I., García-Prieto, C. F., Trueba-Sáiz, A., Gilarranz, A. M., & Rodriguez, J. M. F. (2023). Diagnosis of heart failure with preserved ejection fraction: A systematic narrative review of the evidence. Heart Failure Reviews. https://doi.org/10.1007/s10741-023-10360-z

Gard, E., Nanayakkara, S., Kaye, D., & Gibbs, H. (2020). Management of heart failure with preserved ejection fraction. Australian Prescriber, 43(1), 12–17. https://doi.org/10.18773/austprescr.2020.006

Golla, M. S. G., & Shams, P. (2024). Heart failure with preserved ejection fraction (HFpEF). PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK599960/#:~:text=Diuretics%2C%20angiotensin%20receptor%E2%80%93neprilysin%20inhibitors

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Week 4i-Human Virtual Patient Encounter – Cardiovascular Assessment
See list of diagnostic tests at the end
I. Reflection: Address the following questions:
1. Which diagnostic tests did you select for this client? Using the estimated national average cost for each diagnostic test from a website such as MD save links to an external site., calculate the total cost for diagnostic testing for this client if she was uninsured and did not meet age requirements for Medicare. How might this information change your decision to order diagnostic tests for the client? Would lack of insurance change your management plan? Why or why not?

a. The client in this encounter would likely benefit from community and health care support services. Which services might you recommend? What is available in your community? What is the process of referral in your area?
2. Include the following components:
a. write 150-300 words in a Microsoft Word document
b. demonstrate clinical judgment appropriate to the virtual patient scenario
c. cite at least one relevant scholarly source as defined by program expectations
d. communicate with minimal errors in English grammar, spelling, syntax, and punctuation

Management Plan
Diagnosis: CHF/Heart Failure with preserved ejection fraction (HFpEF)
Diagnostic Test:
12 lead electrocardiogram ECG: Normal sinus rhythm with left ventricular hypertrophy(LVH) and with left atrial enlargement Heart rate 92
Arterial blood gas ABG: PaO2 36, PaCO2 36, SaO2 arterial 71%
BNP:10 high
Cardiac nuclear stress test Lexiscan: The stress test revealed no ischemic ECG changes, nuclear imaging was normal without perfusion defects on stress or with exertion.
CBC: Mild leukocytosis and mild anemia
Echocardiogram TTE: left ventricular hypertrophy with impaired diastolic filling, left ventricular ejection fraction is 55%, aortic sclerosis without stenosis, no other valve abnormalities.
Troponin I: less than 0.03 normal
CT pulmonary angiogram CTPA: Cardiomegaly with increased systemic central venous volume, pulmonary effusions present bilaterally.

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