Lydia is a retired nurse. She is 63 years old. As a child she had rheumatic fever. At the age of 34 she had a mitral valve replaced. She is 10% over her ideal body weight. She used to be quite active...

Lydia is a retired nurse. She is 63 years old. As a child she had rheumatic fever. At the age of 34 she had a mitral valve replaced. She is 10% over her ideal body weight. She used to be quite active when she was working, but she has slowed down a lot with retirement. She has noticed bouts of dizziness and sometimes she thought she was close to fainting. Other times her heart seemed to race. She thought that maybe she needed to see a cardiologist and so she set up an appointment for a cardiac evaluation. Her examination included x-rays, EKG, blood pressure measurement, and a full cardiac workup. The results showed a mild pulmonary congestion, an enlarged left atrium and ventricle. Cardiac output was 3.0 L/ min, blood pressure was 101/57, left atrial pressure was 17 mm Hg, and the right ventricular pressure was 44/8 mm Hg. The EKG indicated an atrial arrhythmia and there appeared to be some valvular regurgitation when the cardiologist listened to her heart sounds. Include references below. Include references below.

1. Based on the information provided what do you think is going on? Do you think there is any relationship between the present condition and the history of rheumatic fever? If so, explain the relationship. If not, why not?
2. Define the terms arrhythmia, tachycardia, and fibrillation. What can explain the arrhythmia? The tachycardia? What is the significance of the fibrillation?
3. What is the outlook for this 63-year-old woman?
4. What would you suggest as a strategy for improving her health as she ages?
5. Do you think this problem has anything to do with her blood lipids or her diet?