History of Present Problem: 

William Butch´ Welka is a 72-year-old male with a history of heart failure, COPD, hypertension, diabetes type II and dementia who has been hospitalized for exacerbation of heart failure three times the past six months. He has been a resident of Pineville Estates, a local long-term care facility, the past four months because his dementia progressed and his wife, Rita, was unable to care for him.

1. RELEVANT Data from Present Problem?

2. Clinical Significance?

Answer:

1. RELEVANT DATA--

the patient is elderly 72 years old male and has a history of heart failure, hypertension, chronic obstructive pulmonary disease, type II diabetes mellitus, dementia. Also he had been hospitalized for heart failure three times within six months.

2. CLINICAL SIGNIFICANCE--

Dementia is a chronic deterioration of nervous system and the cognitive function . Though the patient remains conscious but remarkable difference means decrese in memory, calculation, thinking.

The most common cause is alzheimer's diease and also stroke is an important cause.

In this case, as the patient has long history of heart failure for three times in six months also poorly controlled type 2 diabetes mellitus, COPD, hypertension the dementia is caused. Firstly, the most common complication of hypertension is the heart attack, stroke . On the other hand , in longterm complication of type 2 diabetes mellitus macrovascular complications is seen and which present like stroke, abnormal deposition of protein and lipid , atherosclerosis.

Here in this case, the dementia most probably caused due to long term complication of these painful diseases like COPD, heart failure, hypertension, type 2 diabetes mellitus.