Case 24 – History


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Case 24

History of coronary artery bypass graft and recent back surgery


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Brief History

The patient was an elderly Latino man with a history of four-vessel coronary artery bypass (remote), insulin-requiring diabetes, and liver transplant (remote).

He was in his usual state of health and working until approximately one year ago when he had back pain requiring surgery.

The subsequent year was marked by concern for dementia, 70 lb. weight loss and admission to a nursing home.

The patient had a witnessed sudden cardiopulmonary arrest and died.


Next: External exam

Discussion Questions

1. Summarize the history.

2. What are the short and long-term complications of coronary artery bypass graft surgery. Which have an anatomic basis and what is the change that occurs? Which are related to the body’s natural reaction to the surgery? Which may be related to the operative procedure? Which may be related to the patient’s self-care choices?