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According to the source provided by Klatt, the risk of myocardial infarction is increased by the implications of hypertension, indicating that withdraw from one's medication as in the case of the patient in our case study can lead to the pairing of "increased intraventricular pressure and myocardial contraction." (Klatt, 1) These, in turn, can lead to the type of constricted bloodflow that is likely to invoke heart failure. Therefore, in the case study at hand, the patient is categorically at a high risk for fatality relative to her condition when on regular blood pressure medication. Also, based on Franklin's connection of delusion to heightened anxiety, and on the connection drawn in the discussion on antihypertensive drugs between anxiety and high blood pressure, it seems clear that the erratic and emotionally unstable nature of the delusional state will provoke an added strain on the cardiovascular system.
The treatment modality for both myocardial infarction and high blood pressure needs to be based on the return of the patient to regular medication habits. The treatment modality for delusion should in this instance -- where an aversion to medication is already apparent -- should be to engage in discursive therapy with the patient. It is crucial for a therapist to help the patient identify the factors which caused her to...
This could include attempting to deconstruct the logic of this decision vs. The benefits in returning to the usage of medication. This could, and ethically should, also include discussion of other treatment approaches available with respect to the two cardiac conditions discussed. Incorporated into such a discussion would include consultation with nursing and physician personnel who can elaborate on the pros and cons of other treatment approaches in comparison.
Ultimately though, in spite of questions as to mental or rational competency, it will be the patient's decision on how treatment proceeds. Therefore, treatment of delusion and the manner in which it has distorted ideas or information relating to medication decisions is of the greatest importance in resolving the case study's primary impasse.
Works Cited:
Franklin, K. (1997). Delusions in the Forensic Context. Karen Franklin, Forensic Psychologist. Online at http://www.karenfranklin.com/topix2-delusions.html
Klatt, E.C. (2009). Myocardial Infarction. The University of Utah. Online at http://library.med.utah.edu/WebPath/TUTORIAL/MYOCARD/MYOCARD.html
Wikipedia. (2009). Antihypertensive drugs. Wikimedia, Ltd. Inc.
Works Cited:
Franklin, K. (1997). Delusions in the Forensic Context. Karen Franklin, Forensic Psychologist. Online at http://www.karenfranklin.com/topix2-delusions.html
Klatt, E.C. (2009). Myocardial Infarction. The University of Utah. Online at http://library.med.utah.edu/WebPath/TUTORIAL/MYOCARD/MYOCARD.html
Wikipedia. (2009). Antihypertensive drugs. Wikimedia, Ltd. Inc.
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Bibliography Fenton, Drew Evan (2010) Myocardial Infarction. eMedicine. 24 Jun 2010) Online available at: http://emedicine.medscape.com/article/759321-overview Fletcher GF, Balady G, Blair SN, et al. Statement on exercise: benefits and recommendations for physical activity programs for all Americans: a statement for health professionals by the Committee on Exercise and Cardiac Rehabilitation of the Council on Clinical Cardiology, American Heart Association. Circulation. 1996;94:857 -- 862. [PubMed] cited in Williams, Paul T. 2010) Physical Fitness and
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