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Top 7 Medical Case Presentation Templates with Samples and Examples

Sarojit Hazra

How does information expand beyond essential recollection? Facts alone can diminish in value over time. Context and implementation are crucial to form deep connections and roots. Here comes the role of case studies for clinical personnel in the medical field.

In the always-growing healthcare industry, medical case presentation is essential as it is a suggestion for new researchers. A medical case study is a report where a medical practitioner shares a patient's case. It comprises every detail related to patients. It is beneficial for describing a new medical condition, management options, or treatment for diseases.

Medical case presentations contribute significantly to the evolution of medical knowledge and research.

Case study analysis is essential for every business or industry, like the medical industry. It helps in managing the twists and turns of the industry. Want to take some ideas? Have a look at SlideTeam’s blog Case Analysis Templates .

Let us highlight some significant benefits of medical case presentation:

• Case study presentations are extremely good at depicting realistic clinical frameworks.
• It helps to enhance student participation alongside the joy of learning.
• These are ideal for sharing the latest information on the clinical landscape.
• It promotes critical thinking.
• It can also make better clinical outcomes.

If you are in the healthcare sector, another important tool is the medical dashboard. For a deeper insight, quickly take a look at Medical dashboard Templates .

Each of the slides is 100% editable and customizable. The 100% customizable nature of the templates allows you to edit your presentations. The content-ready slides give you the much-needed structure. Below, let’s explore a wide array of ready to use, content ready medical case presentation templates fit for your organization.

Template 1: Case Study on Blockchain Application in Healthcare: Medical Staff Credential Verification

Blockchain is becoming a potential solution to verify medical credentials. Though these are open to the public, they can be restricted through permissions. Are you finding it difficult to understand and implement? SlideTeam introduces this PPT Template that highlights how to operationalize medical staff verification process using blockchain technology. It explains that healthcare-based systems can also be used to verify the credentials of medical staff. Solutions-based blockchain to track the experiences of medical professionals. The PPT slides are designed with suitable icons, designs, graphs and other relevant material. Grab it quickly and draft your case study as per the client’s requirements.

Click to Download

Template 2: Cost Benefits IOT Digital Twins Implementation Use Cases in the Medical Domain

This PPT template is designed to focus on the use cases in the medical domain, including research and development, diagnosis, surgery, medical equipment, etc. The slide offers a brief description of the mentioned use cases to understand the scenario better. Use it as an essential tool and captivate your audience. Get it Now!

Template 3: Major Use Cases for Tracking Medical Assets Asset Tracking and Management IoT 

Want to simplify medical complexities? The asset tracking solution is here to accompany you. It enables the medical sector to locate patients, clinicians, and medications more accurately and quickly. IoT development has made this task much more accessible by guiding you through every significant aspect of a medical asset-tracking solution. Introducing our slide exhibiting use cases of medical tools that can be tracked with IoT technology . Medical assets, including medical tools, medical equipment tracking, medications , etc., are shown in the layout with their use cases and impacts. Each topic is depicted in separate tables with appropriate icons.

Template 4: AIoT Healthcare Applications in Medical Imaging

AIoT is making the medical sector smarter and wiser to improve data management and human-machine interaction. When AIoT is applied to healthcare, enables virtual monitoring and accurate diagnosis of patients to develop a personalized patient experience. Here, we introduce our premium PPT Templates showcasing applications of Artificial Intelligence of Things (AIoT) in radiology. You can provide detailed information about remote diagnosis , personalized treatment , and real-time monitoring. Adapt it now to increase your presentation threshold and educate your audience.

Template 5: Case Study of Leading Medical Devices Manufacturing Organization

An array of disruptive themes is shaping the medical device industry, and cloud computing is one of them. Soon, cloud computing will have a more significant impact on this industry. So, for your convenience, we are presenting our slide covering a case study of blue cloud with lending medical devices manufacturing organization. It covers significant topics like client objective, problem, our solution, and results chronologically. Consisting of three essential stages, this template is excellent for educating and enticing your audience.

Template 6: IoT Technology Use Case for Medical Treatment

IoT, or the Internet of Things, is gaining significance across industries, and the medical sector is no exception. It has taken medical treatment to a new level. This custom-built PowerPoint Template exhibits the use of IoT technology in domains of the healthcare industry. It provides a digital solution for patient treatment. The key elements are primary care, acute care, virtual hospital, etc., which are depicted along with descriptions, benefits, and additional comments. Each illustration is highlighted, colored and has a relevant icon for instantaneous identification. 

Template 7: IoT Medical Healthcare Technology Use Cases

The transformation of healthcare into digital healthcare has resulted in the rise of IoMT, or medical IoT . It refers to connected devices in medical healthcare and has become one of the fastest-growing industries in the IoT market. It would help if you dived deeper to manage, monitor, and preserve IoT devices in medical healthcare. This PPT presentation demonstrates uses of IoT Medical Healthcare Technology in monitoring patient health. Moreover, the slide includes remote patient monitoring, reduced waiting time, identifying chronic diseases, and drug management. Download this template design and present your case study with ultimate professionalism.

HEALTH CONSULTATION WILL BE QUICKER, SAFER AND SECURE

Case studies have a great history as an educational tool for clinicians. These are highly beneficial for nurturing deeper insights and learning. Access to such visually appealing and comprehensively presented Top 7 Medical Case Presentation Templates enables medical professionals to quickly present their patients' case studies. Be it tracking of medical assets, application of IoT in the clinical field, IoT medical healthcare technology uses, and so on, these templates serve as essential equipment in implementing all.

P.S. For perfection and success, you should dig into SlideTeam's fantastic blog, Medical Report Templates .

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Home Blog Business How to Present a Case Study: Examples and Best Practices

How to Present a Case Study: Examples and Best Practices

Marketers, consultants, salespeople, and all other types of business managers often use case study analysis to highlight a success story, showing how an exciting problem can be or was addressed. But how do you create a compelling case study and then turn it into a memorable presentation? Get a lowdown from this post! 

Table of Content s

• Why Case Studies are a Popular Marketing Technique 

Popular Case Study Format Types

How to write a case study: a 4-step framework, how to do a case study presentation: 3 proven tips, how long should a case study be, final tip: use compelling presentation visuals, business case study examples, what is a case study .

Let’s start with this great case study definition by the University of South Caroline:

In the social sciences, the term case study refers to both a method of analysis and a specific research design for examining a problem, both of which can generalize findings across populations.

In simpler terms — a case study is investigative research into a problem aimed at presenting or highlighting solution(s) to the analyzed issues.

A standard business case study provides insights into:

• General business/market conditions 
• The main problem faced 
• Methods applied 
• The outcomes gained using a specific tool or approach

Case studies (also called case reports) are also used in clinical settings to analyze patient outcomes outside of the business realm. 

But this is a topic for another time. In this post, we’ll focus on teaching you how to write and present a business case, plus share several case study PowerPoint templates and design tips! 

Why Case Studies are a Popular Marketing Technique 

Besides presenting a solution to an internal issue, case studies are often used as a content marketing technique . According to a 2020 Content Marketing Institute report, 69% of B2B marketers use case studies as part of their marketing mix.

A case study informs the reader about a possible solution and soft-sells the results, which can be achieved with your help (e.g., by using your software or by partnering with your specialist). 

For the above purpose, case studies work like a charm. Per the same report: 

• For 9% of marketers, case studies are also the best method for nurturing leads. 
• 23% admit that case studies are beneficial for improving conversions. 

Moreover, case studies also help improve your brand’s credibility, especially in the current fake news landscape and dubious claims made without proper credit. 

Ultimately, case studies naturally help build up more compelling, relatable stories and showcase your product benefits through the prism of extra social proof, courtesy of the case study subject. 

Most case studies come either as a slide deck or as a downloadable PDF document. 

Typically, you have several options to distribute your case study for maximum reach:

• Case study presentations — in-person, virtual, or pre-recorded, there are many times when a case study presentation comes in handy. For example, during client workshops, sales pitches, networking events, conferences, trade shows, etc. 
• Dedicated website page — highlighting case study examples on your website is a great way to convert middle-on-the-funnel prospects. Google’s Think With Google case study section is a great example of a web case study design done right.

• Blog case studies — data-driven storytelling is a staunch way to stand apart from your competition by providing unique insights, no other brand can tell. 
• Video case studies — video is a great medium for showcasing more complex business cases and celebrating customer success stories.

Once you decide on your case study format, the next step is collecting data and then translating it into a storyline. There are different case study methods and research approaches you can use to procure data. 

But let’s say you already have all your facts straight and need to organize them in a clean copy for your presentation deck. Here’s how you should do it. 

1. Identify the Problem 

Every compelling case study research starts with a problem statement definition. While in business settings, there’s no need to explain your methodology in-depth; you should still open your presentation with a quick problem recap slide.

Be sure to mention: 

• What’s the purpose of the case study? What will the audience learn? 
• Set the scene. Explain the before, aka the problems someone was facing. 
• Advertise the main issues and findings without highlighting specific details.

The above information should nicely fit in several paragraphs or 2-3 case study template slides

2. Explain the Solution 

The bulk of your case study copy and presentation slides should focus on the provided solution(s). This is the time to speak at length about how the subject went from before to the glorious after. 

Here are some writing prompts to help you articulate this better:

• State the subject’s main objective and goals. What outcomes were they after?
• Explain the main solution(s) provided. What was done? Why this, but not that? 
• Mention if they tried any alternatives. Why did those work? Why were you better?

This part may take the longest to write. Don’t rush it and reiterate several times. Sprinkle in some powerful words and catchphrases to make your copy more compelling.

3. Collect Testimonials 

Persuasive case studies feature the voice of customer (VoC) data — first-party testimonials and assessments of how well the solution works. These provide extra social proof and credibility to all the claims you are making. 

So plan and schedule interviews with your subjects to collect their input and testimonials. Also, design your case study interview questions in a way that lets you obtain quantifiable results.

4. Package The Information in a Slide Deck

Once you have a rough first draft, try different business case templates and designs to see how these help structure all the available information. 

As a rule of thumb, try to keep one big idea per slide. If you are talking about a solution, first present the general bullet points. Then give each solution a separate slide where you’ll provide more context and perhaps share some quantifiable results.

For example, if you look at case study presentation examples from AWS like this one about Stripe , you’ll notice that the slide deck has few texts and really focuses on the big picture, while the speaker provides extra context.

Need some extra case study presentation design help? Download our Business Case Study PowerPoint template with 100% editable slides. 

Your spoken presentation (and public speaking skills ) are equally if not more important than the case study copy and slide deck. To make a strong business case, follow these quick techniques. 

Focus on Telling a Great Story

A case study is a story of overcoming a challenge, and achieving something grand. Your delivery should reflect that. Step away from the standard “features => benefits” sales formula. Instead, make your customer the hero of the study. Describe the road they went through and how you’ve helped them succeed. 

The premises of your story can be as simple as:

• Help with overcoming a hurdle
• Gaining major impact
• Reaching a new milestone
• Solving a persisting issue no one else code 

Based on the above, create a clear story arc. Show where your hero started. Then explain what type of journey they went through. Inject some emotions into the mix to make your narrative more relatable and memorable. 

Experiment with Copywriting Formulas 

Copywriting is the art and science of organizing words into compelling and persuasive combinations that help readers retain the right ideas. 

To ensure that the audience retains the right takeaways from your case study presentation, you can try using some of the classic copywriting formulas to structure your delivery. These include:

• AIDCA — short for A ttention, I nterest, D esire, C onviction, and A ction. First, grab the audience’s attention by addressing the major problem. Next, pique their interest with some teaser facts. Spark their desire by showing that you know the right way out. Then, show a conviction that you know how to solve the issue—finally, prompt follow-up action such as contacting you to learn more. 
• PADS — is short for Problem, Agitation, Discredit, or Solution. This is more of a sales approach to case study narration. Again, you start with a problem, agitate about its importance, discredit why other solutions won’t cut it, and then present your option. 
• 4Ps — short for P roblem, P romise, P roof, P roposal. This is a middle-ground option that prioritizes storytelling over hard pitches. Set the scene first with a problem. Then make a promise of how you can solve it. Show proof in the form of numbers, testimonials, and different scenarios. Round it up with a proposal for getting the same outcomes. 

Take an Emotion-Inducing Perspective

The key to building a strong rapport with an audience is showing that you are one of them and fully understand what they are going through. 

One of the ways to build this connection is by speaking from an emotion-inducing perspective. This is best illustrated with an example: 

• A business owner went to the bank
• A business owner came into a bank branch 

In the second case, the wording prompts listeners to paint a mental picture from the perspective of the bank employees — a role you’d like them to relate to. By placing your audience in the right visual perspective, you can make them more receptive to your pitches. 

One common question that arises when creating a case study is determining its length. The length of a case study can vary depending on the complexity of the problem and the level of detail you want to provide. Here are some general guidelines to help you decide how long your case study should be:

• Concise and Informative: A good case study should be concise and to the point. Avoid unnecessary fluff and filler content. Focus on providing valuable information and insights.
• Tailor to Your Audience: Consider your target audience when deciding the length. If you’re presenting to a technical audience, you might include more in-depth technical details. For a non-technical audience, keep it more high-level and accessible.
• Cover Key Points: Ensure that your case study covers the key points effectively. These include the problem statement, the solution, and the outcomes. Provide enough information for the reader to understand the context and the significance of your case.
• Visuals: Visual elements such as charts, graphs, images, and diagrams can help convey information more effectively. Use visuals to supplement your written content and make complex information easier to understand.
• Engagement: Keep your audience engaged. A case study that is too long may lose the reader’s interest. Make sure the content is engaging and holds the reader’s attention throughout.
• Consider the Format: Depending on the format you choose (e.g., written document, presentation, video), the ideal length may vary. For written case studies, aim for a length that can be easily read in one sitting.

In general, a written case study for business purposes often falls in the range of 1,000 to 2,000 words. However, this is not a strict rule, and the length can be shorter or longer based on the factors mentioned above.

Our brain is wired to process images much faster than text. So when you are presenting a case study, always look for an opportunity to tie in some illustrations such as: 

• A product demo/preview
• Processes chart 
• Call-out quotes or numbers
• Custom illustrations or graphics 
• Customer or team headshots 

Use icons to minimize the volume of text. Also, opt for readable fonts that can look good in a smaller size too.

To better understand how to create an effective business case study, let’s explore some examples of successful case studies:

Apple Inc.: Apple’s case study on the launch of the iPhone is a classic example. It covers the problem of a changing mobile phone market, the innovative solution (the iPhone), and the outstanding outcomes, such as market dominance and increased revenue.

Tesla, Inc.: Tesla’s case study on electric vehicles and sustainable transportation is another compelling example. It addresses the problem of environmental concerns and the need for sustainable transportation solutions. The case study highlights Tesla’s electric cars as the solution and showcases the positive impact on reducing carbon emissions.

Amazon.com: Amazon’s case study on customer-centricity is a great illustration of how the company transformed the e-commerce industry. It discusses the problem of customer dissatisfaction with traditional retail, Amazon’s customer-focused approach as the solution, and the remarkable outcomes in terms of customer loyalty and market growth.

Coca-Cola: Coca-Cola’s case study on brand evolution is a valuable example. It outlines the challenge of adapting to changing consumer preferences and demographics. The case study demonstrates how Coca-Cola continually reinvented its brand to stay relevant and succeed in the global market.

Airbnb: Airbnb’s case study on the sharing economy is an intriguing example. It addresses the problem of travelers seeking unique and affordable accommodations. The case study presents Airbnb’s platform as the solution and highlights its impact on the hospitality industry and the sharing economy.

These examples showcase the diversity of case studies in the business world and how they effectively communicate problems, solutions, and outcomes. When creating your own business case study, use these examples as inspiration and tailor your approach to your specific industry and target audience.

Finally, practice your case study presentation several times — solo and together with your team — to collect feedback and make last-minute refinements! 

1. Business Case Study PowerPoint Template

To efficiently create a Business Case Study it’s important to ask all the right questions and document everything necessary, therefore this PowerPoint Template will provide all the sections you need.

Use This Template

2. Medical Case Study PowerPoint Template

3. Medical Infographics PowerPoint Templates

4. Success Story PowerPoint Template

5. Detective Research PowerPoint Template

6. Animated Clinical Study PowerPoint Templates

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Chapter 1:  10 Real Cases on Acute Coronary Syndrome: Diagnosis, Management, and Follow-Up

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Case 1: Diagnostic Evaluation of Chest Pain

A 65-year-old man presented to the emergency department with a complaint of left-sided chest pain radiating to his left arm. There were no alleviating factors. His past medical history included hypertension, uncontrolled diabetes mellitus, and hyperlipidemia. He denied any toxic habits. His baseline exercise tolerance is 2 city blocks limited by fatigue. Upon presentation, vital signs were stable and the physical examination was unremarkable. The chest pain was partially relieved by sublingual nitroglycerin. The 12-lead ECG showed nonspecific T-wave inversions in the inferolateral leads. He was administered aspirin, and the chest pain resolved shortly thereafter. Subsequently, he was admitted to the telemetry floor for further evaluation and observation. His serial cardiac biomarkers were negative. He did not have any recurrent chest pain and remained hemodynamically stable throughout the hospital stay. How would you manage this case?

In this clinical scenario, the patient does not fit the complete picture of anginal symptoms. However, the key here is the presence of risk factors and subtle 12-lead ECG changes, which place him at an elevated risk for coronary artery disease. He can be further evaluated by stress testing for risk stratification.

Angina consists of retrosternal chest pain increased by activity or emotional stress and generally relieved by rest or administration of nitroglycerin. The evaluation of chest pain begins with a thorough history and physical examination to delineate the etiology. The list of differential diagnoses is vast, and a detailed review of systems about pertinent diagnoses can narrow down the list. The presence of comorbid conditions and risk factors might hint toward a diagnosis of coronary artery disease. Both serial 12-lead ECG and highly sensitive cardiac troponin T testing should be performed before excluding ongoing ischemic coronary artery disease. Prior to stress testing, the patient should be chest pain free for 24 hours, without dynamic 12-lead ECG changes, and the highly sensitive cardiac troponin T level should be negative or trending downward.

The differential diagnosis of chest pain includes the following:

Coronary artery disease

Aortic dissection

Pericarditis

Pulmonary embolism

Costochondritis/rib fracture

Peptic ulcer disease

Acute cholecystitis

Cervical radiculopathy

Herpes zoster

Anxiety disorder

Chest pain should be classified as anginal or nonanginal based on the history.

Anginal symptoms can be considered in the setting of risk factors and should be evaluated by an appropriate stress modality if the symptoms are vague.

Serial 12-lead ECG and highly sensitive cardiac troponin T should be performed to exclude ongoing ischemic coronary artery disease before stress testing is performed.

Case 2: Diagnosis of Acute Coronary Syndrome

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Clinical Case

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Clinical case reports have been the earliest form of medical communication. A clinical case report or case study is a means of disseminating new knowledge gained from clinical practice. Medical practitioners often come across patient cases that are different or unusual such as a previously unknown condition, a complication of a known disease, an unusual side effect or adverse response to a mode of treatment, or a new approach to a common medical condition. Thus, a clinical case report is expected to discuss the signs, symptoms, diagnosis, and treatment of a disease.

Clinical case reports are the first-line evidence in medical literature as they present original observations and can be an excellent way for medical students and practitioners to get started with academic writing. Additionally, a published case report is definitely a contribution to medical science and a great addition to a CV.

Informed consent in an ethical requirement for most studies involving humans. It is important to take written consent from the patient before you start writing your case report as all journals will require you to provide patient consent at the time of manuscript submission. In case the patient is a minor, parental consent is required.  For adults who are unable to consent to investigation or treatment, consent of closest family members is required. In general, all case reports include the following components – an abstract, an introduction, a case, and a discussion. 

The abstract should summarize the case, the problem it addresses, and the message it conveys. Abstracts of case studies are usually very short, preferably not more than 150 words. The introduction gives a brief overview of the problem that the case addresses, citing relevant literature where necessary. The introduction generally ends with a single sentence describing the patient and the basic condition that he or she is suffering from.

Case studies are a vehicle for doctors around the world to share their experiences with handling challenging patient cases. These can be valuable sources of information and guidance for clinical practitioners when faced with puzzling or challenging conditions in patients they attend to.

This template will be useful for healthcare professionals and doctors when preparing a report on a new type of disease or a new symptom of a disease. You can structure and present your new patient data. Also, this template can be used for training with interns, which will be conducted by experienced hospital doctors.

Also, this template will be useful for specialists in research centers and pharmaceutical companies. You can use the slides in this template to prepare for a Doctorate Symposium or to speak to medical students.

Clinical Case Template is a stylish and professional template that contains four slides. All slides in the template can be easily customized to suit your corporate color requirements. Clinical Case Template will be useful for doctors and medical professionals, teachers of medical universities. This template’s slides will be a great addition to your professional presentation collection.

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Patient Case Presentation

Patient presentation.

Mr. Smith is a 60-year-old Caucasian male, who presents with 8/10 chest pain after working out. He just quit smoking and started a new workout and diet program after recently retiring. He has noticed some chest and shoulder discomfort with working out that usually resolves with rest, but decided to come to the emergency department because this episode was unrelenting and more severe. Mr. Smith describes his current pain as severe and sharp, and also complains of nausea and shortness of breath. Vital signs are HR: 110 BP: 150/90 RR: 30 Temp 97.6 O2 Sat: 92% on 2L nasal cannula, EKG shows ST segment elevation in leads II, III and AVf. Labs were drawn, including an elevated troponin (4.23 ng/ml), and slightly elevated white blood cell count (13.6 × 10 9 /L) .

Past Medical History

Type II diabetes (age 47), dyslipidemia (age 33), atherosclerosis (age 52), hypertension (age 49), obesity (age 33), viral pneumonia (age 29), hiatal hernia (age 28), peptic ulcer disease (age 41)

Family Medical History

Mother (deceased) – atrial fibrillation (diagnosed at age 45), died of MI (age 65)

Father (83) – obesity, type II diabetes (diagnosed at 50), COPD (diagnosed at 55)

Social History

Smoker (20 pack years), worked in an office sitting at a desk his whole career (35 years), recently began working out at his local gym since retiring this year.

Case study 1: acute myocardial infarction

Sep 12, 2014

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Case study 1: acute myocardial infarction. Megan Fuchs Good Sam Dietetic Intern January 5, 2012. Patient Profile Personal Information. 46 year old white male Lives in Cincinnati, OH with wife, daughter, and grandson Leads a physically active lifestyle

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• kcal intake
• current admission
• high blood pressure
• diet education low sodium

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Case study 1: acute myocardial infarction Megan Fuchs Good Sam Dietetic Intern January 5, 2012

Patient ProfilePersonal Information • 46 year old white male • Lives in Cincinnati, OH with wife, daughter, and grandson • Leads a physically active lifestyle • Works in maintenance – constant movement • Lifts weights and swims regularly • No ethnic or religious considerations

Patient ProfileAdmission • JD presented to the Western Ridge ER with complaints of chest pain, N/V, and diaphoresis • Found to be having an acute inferior myocardial infarction (MI) • Immediately transferred to GSH ER • At GSH, doctors confirmed the diagnosis of an acute inferior MI based on • EKG results consistent with MI • Noted sinus arrhythmia • Rate of 89 • Marked segment elevation in inferior leads

Patient profilePast medical History • Splenectomy(as a child, unknown reason for removal) • Surgical removal of the spleen due to rupture, enlargement, certain blood disorders, cancer, infections, or non-cancerous tumors • Spleen is an important part of fighting infection – filters damaged red blood cells • Complications may include hemorrhage, blood clots, infection, or injury to other organs • Hypertension(HTN) • High blood pressure • Diagnosed when ones blood pressure is 140/80 mmHg • Factors affecting BP include amount of water and salt in the body; function of the kidneys, nervous system, and blood vessels • Increased risk of developing HTN if one is obese, stressed/anxious, high salt diet, family history, diabetes, smoker, or African American

Patient ProfileFamily History Very strong history of heart failure

Patient profileHealth History • Generally sleeps well, 6-8 hours a night • Physically Active Lifestyle • Maintenance worker – uses stairs, walks to and from buildings • Lifts weights and swims 3-4 times/week • Non-smoker • Occasionally drinks alcohol • No substance abuse

Patient ProfileHealth History • Height: 5’9” • Weight: 267.7 lb • Weight history: 5 lb weight gain/loss throughout the year • No large amount of weight loss or gain • Appetite • Prior to admission – very good appetite, enjoys all foods but eats very little vegetables • JD and his wife enjoy shopping and cooking together • During hospital stay – appetite improved but was initially very poor

Patient profilehealth history • No dental problems • No chewing or swallowing problems • Normal digestion • Elimination – regular bowel movements

Disease BackgroundAcute Inferior Myocardial infarction • Myocardial Infarction or Heart Attack • Occurs when blood flow to part of the heart is blocked resulting in damage or death to the muscle • Usually caused by a blood clot or plaque formation blocking the coronary artery, which supplies the heart with oxygen and blood

Disease BackgroundPathophysiology/etiology • Most common etiologic factor: presence of atherosclerotic plaque blocking the coronary arteries • Plaque leads to the disruption of blood flow through the coronary arteries to the heart • Size of the thrombus determines the percent of blockage, ultimately determining the extent of damage • Decreased blood flow for an amount of time can trigger a process known as ischemic cascade • Causing the heart muscle to die and potentially resulting in cardiac arrhythmia

Disease BackgroundSymptoms • Most often characterized by • Chest pain • Tightness in chest • Feeling of heaviness in the chest area • Nausea • Vomiting • SOB • Sweating • Often mistaken for heart burn or indigestion during initial onset • Usually chest pain or tightness will last longer than 20 minutes and increase in intensity

Medical DiagnosisTreatment • Initial Treatment • Nitroglycerin or morphine to numb chest pain • Angioplasty for stent placement to unclog artery – most common emergency treatment • Drug therapy to break apart clots – thrombolytic therapy • Open heart surgery – most severe cases • After initial treatment • Medication to help protect the heart from future cardiovascular events – blood thinner, beta-blocker, or ACE inhibitor • Lifestyle changes • Slowly incorporating exercise • Changing dietary habits • Maintaining control of BP, blood sugar, and cholesterol levels

Disease BackgroundNutritional Intervention Low sodium, low fat, low cholesterol ≤ 30% total kcal from fat – less than 1/3 of those kcal should be saturated 200 mg/day cholesterol Sodium Weigh loss if overweight should be stressed

Disease BackgroundEvidenced Based Research • The New England Journal of Medicine • Goal: to determine if salt reduction in diet would decrease cardiovascular disease • The effects of salt reduction in association with CVD was compared • Decrease in cost of HTN medication was determined • Results • Reducing dietary salt to 3gm a day would reduce new cases of • CHD by 60,000-120,000 • MI by 54,000-99,000 • Stroke by 32,000-66,000 • Medical costs related to CVD would decrease by 10 billion to 24 billion dollars annually

Disease BackgroundPrognosis • Usually, patients without complications can return to normal activity – slowly! • The prognosis is dependent on how much of the heart muscle was damaged • Amount of damage will determine how fast one returns to normal activities • Level of damage may cause arrhythmia, valve problems, or heart rupture • If the heart is no longer able to pump blood as well as it used to, heart failure may be a concern

Application to patient • Initial Diagnosis: Acute Inferior Myocardial Infarction • November 20, 2011 • Symptoms: Chest pain (7 out of 10), nausea, vomiting, and diaphoresis • Sinus arrhythmia, marked segment elevation of inferior leads • Symptoms lasting 2 hr total • JD had a very good understanding of his diagnosis • Although discouraged because he lead an active lifestyle • Unaware of unhealthy eating habits in relation to diagnosis • Connection to strong family history of heart disease

Current Admission • Diagnosis • Acute Inferior Myocardial Infarction • Diagnostic procedures • Metabolic panel, chest panel, and complete blood count • Echocardiogram showed mild decrease in the left atrium, left ventricular function decreased, ejection factor of 45-50%, and trace mitral regurgitation • Chest x-ray found the trachea, heart, and mediastinal structures to be normal, along with clear lungs and pleural spaces

Current admission • Diagnostic procedures cont. • Coronary angiography summary noted • dominant right system single vessel disease • left ventriculography demonstrated severe inferior hypokinesis • The right coronary artery was proximally occluded and enlarged with no collateralization • Initially JD’s cardiac enzymes were • CK: 252 • MB: 4.4 • Troponin: 0.01

Current AdmissionTreatment Stent placement to the right coronary artery occlusion JD was started on the beta-blocker Carvedilol to control his hypertension and treat his valve dysfunction in combination with a statin JD was also prescribed plavix and advised to take an aspirin to help avoid future cardiovascular events

Current AdmissionMedications • Chewable Aspirin • Colace • Coreg • Heparin • Lipitor • Maalox • Morphine • Nitroglycerin • Plavix • Prinivil • Tylenol • Xanax • Zofran

Nutrition Care ProcessNutrition Assessment • Current Diet Order • Cardiac: low fat/cholesterol, 3 gram Na, 0 caffeine • Diet History • Prior to admission JD did not follow any specific diet restrictions; 3 meals a day with an evening snack • Fast food (White Castle, Skyline), Sit down restaurants (Applebee’s 1-2 times/week), and home cooked meals (~4 times/week) • Ate very little vegetables; liked apples, oranges, and grapes; drank 2% milk • Both JD and his wife cook and grocery shop together • JD expressed interest in learning new recipes and substituting items to make each meal more heart healthy

Nutrition Care ProcessNutrition Assessment • 24 hour recall • 25% po intake at breakfast – couple bites of low sodium scrambled eggs and whole wheat english muffin with a small amount of jelly, few sips of orange juice • 100% po intake at lunch – meatloaf, red skin mashed potatoes, vegetable medley (corn, red peppers, green beans), dinner roll, and 4 oz apple juice • 100% po intake at dinner – oven baked chicken, sliced potatoes, vegetables (yellow squash, carrots, and peppers), and 8 oz skim milk • JD avoided his deserts because he is not big on sweets

Nutrition Care ProcessNutrition Assessment • JD had no prior MNT • Prior to admission JD clearly stated he ate few, if any vegetables and likes some fruits. Also, most of his meals during the week consist of fast food. JD’s diet is mainly high fat, high sodium foods • While in the hospital, JD received well balanced meals, and surprisingly he ate the vegetables! • Level of nutritional risk: moderate risk due to high-risk diagnosis and obesity (167% IBW)

Nutrition Care ProcessNutritionAssessment Anthropometrics Biochemical Labs • Height: 5’9” • Weight: 267.7 lb (122 kg) • IBW: 160 lb ± 10% • %IBW: 167% • ABW: 187 lb (85 kg) • Usual wt: 250 lb (114 kg) • % weight change: +7% • BMI: 39.45 kg/m2

Nutrition care processnutrition assessment Macronutrient Needs Calories: 2125 kcal (25 kcal/kg ABW) Protein: 68-85 gm (0.8-1.0 gm/kg ABW) Carbohydrates: 292 gm/day (55% total kcal) Fat: 71 gm/day (30% total kcal) *16.5 gm saturated fat/day (7% total fat)

Nutrition Care ProcessNutrition Diagnosis • Nutrition Diagnosis • NC-3.3 Overweight/obesity • PES Statement • Overweight/obesity related to excessive kcal intake as evidenced by 167% IBW and a BMI of 39.45 kg/m2 • Goals included appropriate weight loss, appropriate oral intake, and appropriate kcal intake • Recommendation • A critical aspect of JD’s recovery is a decrease in weight and a more restrictive diet than he was used to – diet education is key in preventing future cardiac events

Nutrition Care ProcessNutrition Intervention • Plan • Limit foods high in fat, cholesterol, and sodium • Cholesterol intake should be < 200 mg/day • Total percent of fat from kcal should be ≤ 30% • Increase MUFA and decrease saturated fats (7% of kcal/day) • Decreasing total kcal intake to obtain appropriate weight loss • Implement • Provided JD with a list of heart healthy foods • Explained what foods were high in fat, cholesterol, and sodium • Reviewed sources of saturated fat and MUFA • Explained how to read a nutrition fact label • Provided tips eating out • Diet education – low sodium, low fat, low cholesterol – and weight loss are the most important nutrition interventions for JD.

Nutrition Care ProcessMonitoring and Evaluation • While in the hospital JD was receiving a cardiac diet per MD order • Extensive diet education was provided • JD expressed great intentions to follow a low fat, low cholesterol, low sodium diet at home • Monitoring JD’s progress • Keeping track of his daily sodium, cholesterol, and fat intake – comparing day to day • Writing down times a week he eats out and what he ate

Summary • 46 year old male living a moderately active lifestyle • PMH: hypertension and splenectomy • Current medical diagnosis: acute inferior myocardial infarction • Stent placement, EF 45-50% • Medications: carvedilol, aspirin, plavix, statin • Cardiac diet per MD • Educated on importance of low sodium, low fat, low cholesterol diet, along with weight loss • Encouraged to keep records of fat, cholesterol, and sodium for self monitoring

References • Mayo Foundation for Medical Education and Research. Splenectomy. Available at http://www.mayoclinic.com/health/splenectomy/MY01271. Accessed 11/30/2011. • Dugdale, DC. PubMed Health. Hypertension. Available at http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001502/. Accessed 11/30/2011. • Chen, MA. PubMed Health. Heart Attack. Available at http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001246/. Accessed 11/30/2011. • Khera, AV. Cuchel, M. de la Llera-Moya, M. Rodrigues, A. Burke, MF. Jafri, K. French, BC. Phillips, JA. Muchsavage, ML. Wilensky, RL. Mohler, ER. Rothblat, GH. Rader, DJ. Cholesterol Efflux Capacity, High-Density Lipoprotein Function, and Atherosclerosis. N Engl J Med 2011; 364:127-35. • Siri-Tarino, PW. Sun, Q. Hu, FB. Krauss, RM. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J ClinNutr 2010; 91:535-46.

References • Bibbins-Domingo, K. Chertow, GM. Coxson, PG. Moran, A. Lightwood, JM. Pletcher, MJ. Goldman, L. Projected Effect of Dietary Salt Reductions on Future Cardiovascular Disease. N Engl J Med 2010; 362:590-9. • TriHealth, Inc. Eating with your Hearts Consent. The Heart and Vascular Center. • Lee, CD. Jacobs, DR. Schreiner, PJ. Iribarren, C. Hankinson, A. Abdominal Obesity and Coronary Artery Calcification in Young Adults: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J ClinNutr 2007; 86:48-54. • Martin, T. The Normal Range for Creatine Kinase Blood Test. Available at http://www.brighthub.com/science/medical/articles/75706.aspx. Accessed 11/30/2011. • The American Association for Clinical Chemistry. CK-MD, The Test. Available at http://labtestsonline.org/understanding/analytes/ckmb/tab/test. Accessed 11/30/2011. • Pronsky, ZM. Crowe, SR JP. Food Medication Interactions, 16th edition. 2010; p. 3-339. • Khan, S. Myocardial Infarction Pathophysiology. Available at http://www.buzzle.com/articles/myocardial-infarction-pathophysiology.html. Accessed 12/30/11.

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Patient presentation.

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Chief Complaint

“I have severe headaches and fevers.”

History of Present Illness

DJ is a 54-year-old Caucasian female who presents to the emergency department with worsening headache, neck pain, and back pain of 2 days duration. She also complains of low-grade fevers and chills that developed over the past 24 hours. Her son, who is present during her exam, states that she seems more lethargic and has difficulty maintaining her balance. In addition, she reports 3 to 4 episodes of nausea and vomiting.

Past Medical History

CHF, COPD, HTN, epilepsy, stroke, hypothyroidism, anxiety

Surgical History

Hysterectomy, cholecystectomy

Family History

Father had HTN and passed away from a stroke 4 years ago; mother has type II DM and epilepsy; brother has HTN

Social History

Divorced but lives with her two sons who are currently attending college. Smokes ½ ppd × 27 years and drinks alcohol occasionally.

Home Medications

Advair 250 mcg/50 mcg 1 puff BID

Albuterol metered-dose-inhaler 2 puffs q4h PRN shortness of breath

Alprazolam 0.5 mg PO daily

Aspirin 81 mg PO daily

Atorvastatin 20 mg PO daily

Carvedilol 6.25 mg PO BID

Citalopram 20 mg PO daily

Divalproex sodium 500 mg PO BID

Furosemide 20 mg PO daily

Levothyroxine 88 mcg PO daily

Levetiracetam 500 mg PO BID

Lisinopril 20 mg PO daily

Physical Examination

Vital signs.

Temp 101.2°F, P 72, RR 23 breaths per minute, BP 162/87 mm Hg, pO 2 91%, Ht 5′3″, Wt 56.4 kg

Lethargic, female with dizziness and in mild to moderate distress.

Normocephalic, atraumatic, PERRLA, EOMI, pale or dry mucous membranes and conjunctiva, poor dentition

Diminished breath sounds and crackles bilaterally.

Cardiovascular

NSR, no m/r/g

Soft, non-distended, non-tender, bowel sounds hyperactive

Genitourinary

Normal female genitalia, no complaints of dysuria or hematuria

Lethargic, oriented to place and person, (–) Brudzinski’s sign, (+) Kernig’s sign

Extremities

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