Respiration Problems Case Study

Trans-Ischaemic Attacks

The human brain is a sensitive component of the human body, it works as the nerve center of the body commanding and coordinating all its functions. As such this body relies on a constant supply of energy and oxygen which the blood supplies. As one age bodily functions seem to fail one after the other as body tissue stop generating, brain and heart tissue are generally the slowest in reproducing. Any changes to the flow of blood to the brain can be disastrous and at times the damage is irreversible. One such disastrous effect is the occurrence of a trans-ischaemic attack (TIA) which can be roughly described as a mini-stroke. During this attack, there is a brief interruption of the supply of blood to the brain[ CITATION Ama16 l 1033 ]. When such an attack happens it is usually a warning sign for a near future stroke. Age is a big factor in this attack as it is characterized by the slowing down of functions and failure of the body to coordinate its functions properly[ CITATION Str17 l 1033 ]. Patients who suffer such an attack are usually urged to seek immediate medical attention.


The patient’s medical history points to a previous heart problem that may be the cause of the trans-ischaemic attacks that befall the patient. An atrial fibrillation is a condition of the heart that is characterized by irregular heartbeats thus explaining the irregular and thread pulse reading, This condition is known to be common for older people such as the patient with hypertension, medication is usually given to such patients to avoid the occurrence of a stroke. The worsening the TIA is an effect of the heart condition becoming worse thus requiring immediate attention or hospitalization to prevent a future debilitating stroke. The patient’s history of gout can explain the loss of sensation in the fingertips and the inability to grasp objects. The weakness of the body is one of the main signs of a TIA, during such an attack it is not uncommon for the patient to feel weak on one side of the body. A headache being experienced is also one of the prime symptoms of a TIA the problem is usually worse in the moments after the attack and its intensity and patterns usually varies[ CITATION Str17 l 1033 ]. A patient at such a stage needs to get specialized treatment to help manage the stroke just in case the problem develops into an actual stroke. The patient’s low respiration rate is also a sign of a worsening case of the condition and would require that the patient is considered for assisted breathing treatments to ensure that he gets the required oxygen needed for normal bodily functions[ CITATION Abd12 l 1033 ].


For a proper evaluation, it is generally advised for medical professionals to employ the A to E assessment approach to enable them to assess the level of emergency the medical case is at the moment. This approach consists of employing a step by step process to check whether the patient requires being given immediate basic medical treatment. In this process the medical practitioner checks for the following: Airway, Breathing, Circulation, Disability and Exposure (ABCDE). Most if not all medical professionals use this approach in the field to assess their patients and provide an onsite provisional diagnosis. The technique makes it easy to make a diagnosis before a definitive one can be made, it is also an efficient technique for saving lives and preventing the condition from worsening[ CITATION Thi12 l 1033 ].

  1. The patient’s pulse indicates that he has difficulty breathing indicating that there is a partial obstruction of the airway. His shortness of breath and low respiration rate indicates that he may require assisted breathing should the condition worsen.

  2. The patient has a dangerously low respiration rate due to the partial weakening of the left side of the lungs caused by the TIA.

  3. The patient has a normal but irregular and thread pulse indicates that the patient may be having a heart condition that disturbs the flow of blood. The patient’s atrial fibrillation can be said to be the cause of this pulse reading. The patient also has a high blood pressure reading that needs to be addressed as soon as possible to control the TIA condition.

  4. The patient is cannot move around much due to the weakness he feels and gout like feeling in his left leg,

  5. The patient is feeling the effects of age and cerebrovascular disease.


Few diseases affect both the heart and the brain, these diseases are known as cerebrovascular diseases, and these diseases are ones that involve the supply of blood in the brain. These diseases are classified into strokes, TIA, subarachnoid hemorrhage and vascular dementia. They vary according to the severity and permanency. Strokes are the most serious of them, the blood supply to the brain are caused by a rupture of a blood vessel. TIA are not permanent and its symptoms can be confused with those of a stroke[ CITATION Mar161 l 1033 ]. A stroke is also referred to as a cerebral-vascular accident it differs from TIA in that its damage is irreparable and more often permanent while the trans-ischaemic attack is temporary. TIA is very manageable and with care can be cured although it usually warns of a impending stroke.


My recommendation is that the patient undergoes a CT scan to better understand the situation of his brain and if there is a likelihood that the patient will experience a stroke in the near future. Brain activity can help determine the extent of damage to the brain caused by the worsening TIA over time. I would also suggest that the patient undergoes an echocardiogram to understand the blood circulation mechanism to understand if there is a burst blood vessel that is disrupting the flow of blood to the brain as is the case in most cerebral-vascular diseases. A clear understanding of the extent of the patient’s atrial fibrillation is also crucial. The extent of the damage caused by the condition can help explain the disruption of blood supply. A damaged atrium can mean that the heart is not strong enough to pump blood to the brain leading to the condition[ CITATION Str17 l 1033 ].


Treatment for this condition is by addressing the other issues, that is the high blood pressure using medication. High blood pressure is the cause of a persistent headache experienced by the patient. The pain can be alleviated by prescribing painkillers such as aspirin can help ease the patient’s pain that is clearly to blame. By alleviating the effects of the TIA we can be able to make the patient strong enough to manage to move around and gain enough strength. Since the patient was a former chain smoker we can prescribe medication that can help treat the effects of the drug on the respiratory system to help open up the system making it easier for him to breathe normally. Assisted breathing can help the patient with his oxygen deficiency caused by the shortness of breath and poor respiration rate to avoid further brain damage[ CITATION Cra17 l 1033 ].


Taking into account the present situation and the patient’s age it is important that the patient is rushed to a medical facility where he can receive the appropriate treatment that is required to ease the patient’s suffering. Nurses and doctors would be better equipped to monitor and follow up on the patient’s condition better. I would recommend that the patient engages the services of a neurologist and a cardiologist in seeking further advice on how to manage the condition and ways to prevent an occurrence of a stroke that could lead to permanent disability or death.


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