Journal of Case Reports and Clinical Insights in Health

Atypical Presentation of Acute Myocardial Infarction Mimicking Gastrointestinal Pathology in a Young Adult

Moses Phiri — Mon, 11 May 2026 00:00:00 +0000

Acute myocardial infarction classically presents with chest pain; however, atypical presentations without chest discomfort may lead to diagnostic delay and increased morbidity. Gastrointestinal symptoms such as epigastric pain and vomiting can mimic primary abdominal pathology, particularly in young adults perceived to have a low cardiovascular risk. A 29-year-old male presented to the emergency department with six hours of severe epigastric pain (8/10 intensity) accompanied by recurrent vomiting. He denied chest pain or dyspnoea. Electrocardiography demonstrated 2–3 mm ST-segment elevation in leads II, III, and aVF with reciprocal ST depression in leads I and aVL. High-sensitivity troponin I levels were markedly elevated. Emergent coronary angiography revealed a complete thrombotic occlusion of the proximal right coronary artery. The patient underwent successful primary percutaneous coronary intervention with deployment of a drug-eluting stent, restoring TIMI grade 3 coronary flow. Inferior ST-elevation myocardial infarction may present solely with gastrointestinal symptoms even in young adults. Early electrocardiography remains essential in patients presenting with unexplained epigastric pain to prevent delayed reperfusion and adverse outcomes.

Implementation of Combination of Benson Relaxation Therapy and Ki 3 Acupressure Intervention in Elderly People with Joint Pain

Mon, 11 May 2026 00:00:00 +0000

Gout is a condition in which uric acid accumulates excessively in the body, caused by increased uric acid production or the consumption of foods high in purines, leading to joint pain and other symptoms. Complementary therapies that can be done include Benson relaxation therapy, which adds an element of word pronunciation according to the beliefs adhered to, and acupressure therapy, which emphasizes several points on the body's surface as centers of energy circulation. The purpose of this study is to describe the application of a combination of Benson relaxation therapy and Ki3 acupressure among elderly individuals with joint pain at UPT PSTW Pasuruan. The research used a case study design with 1 elderly person aged 73 years who had gout and had been experiencing joint pain for the past 6 months. The research instrument used was the Numeric Rating Scale (NRS) pain scale instrument. The intervention was carried out over 3 days, with 3 meetings, and was accompanied by measurement of the pain scale and uric acid levels before and after the intervention. The data collection technique uses interviews and observations, and the data are presented in a gerontic nursing care report format. The results showed a decrease in pain scale after receiving a combination of Benson relaxation therapy and Ki3 acupressure for 3 consecutive days, from 5 to 2. These results show that Benson relaxation and Ki3 acupressure can be an effective, simple non-pharmacological therapy that can be recommended to reduce joint pain in the elderly.

Application of Ankle Pump Exercise and 30° Leg Elevation in Chronic Kidney Disease Patients with Hipervolemia (Peripheral Edema) in the Anturium of Dr. Soebandi Jember

Azzahra Firdaus, Rondhianto Rondhianto, Lutfiasih Rahmawati, Mustakim Mustakim — Mon, 11 May 2026 00:00:00 +0000

Chronic Kidney Disease (CKD) is a condition in which the kidneys are damaged and cannot filter blood optimally, where one of the clinical manifestations of this condition is peripheral edema. Based on previous research, 59% of CKD patients experienced peripheral edema (83 respondents), followed by other problems: 51.1% were pale, 26.5% had ascites, and 28.9% had pleural effusion. The purpose of this study was to determine the results of the application of ankle pump exercises and 30° leg elevation in CKD patients with hypervolemia (peripheral edema) at the Anturium of Dr. Soebandi Regional Hospital, Jember. After applying ankle pump exercises and 30° leg elevation 3 times a day for 20 minutes for 3 days, the results showed a decrease in edema depth and return time from the first to the third day. The degree of edema on the first day was grade 3; on the second day, grade 2; and on the third day, grade 1, with a depth of 1.1 mm and a return time of 6 seconds. In addition, the results showed improved capillary refill time (< 2 seconds), increased skin turgor in areas outside the edema, a thirst distress score of 13, and moist mucous membranes after the intervention from the first to the third day, with the interpretation that fluid circulation improved. It can be concluded that ankle pump exercises and 30° leg elevation can reduce edema and improve blood circulation in CKD patients with hypervolemia and treatment challenges.

Lavender Aromatherapy as a Complementary Nursing Intervention for Anxiety in an Institutionalized Older Adult with Post-Fracture Mobility Limitation: A Case Report

Sya' roni, Rizkiyani Istifada, Niken Asih Laras Ati, Suprayitno — Mon, 11 May 2026 00:00:00 +0000

Background: Aging is accompanied by physical changes that can impact health and decrease overall well-being, often leading to psychological issues such as anxiety and depression. Non-pharmacological interventions like aromatherapy are believed to provide a calming effect, reduce stress, and improve mood in the elderly. Objective: This study aims to describe nursing care for anxiety in older adults using lavender aromatherapy and relaxation techniques. Method: This case study employed a descriptive-analytical approach with a pre-test and post-test design involving a single participant, an older adult residing at UPT PSTW Bondowoso. The intervention involved administering lavender aromatherapy for 10–15 minutes daily over seven consecutive days via inhalation of three drops of lavender essential oil placed on a cotton pad. Results: After seven sessions of lavender aromatherapy, there was a noticeable decrease in verbal expressions of worry and confusion. Behavioral indicators of restlessness were reduced, and sleep patterns improved. The Geriatric Depression Scale (GDS) score decreased from 9 on the first day to 6 on the final day. Conclusion: Lavender aromatherapy was effective in reducing anxiety and depression levels in the elderly. The results suggest that aromatherapy can be considered a complementary nursing intervention to enhance mental well-being in older adults.

Range of Motion Exercise to Reduce the Fall Risk in Older Adult with Hypertension at the Tresna Werdha Social Care Service Center, Jember: A Case Report

Mon, 11 May 2026 00:00:00 +0000

Falls are a major health concern among older adults, particularly those with chronic conditions such as hypertension that affect balance, muscle strength, and postural stability. This case report describes the nursing management of an older adult with hypertension and high fall risk who received range of motion (ROM) exercise as a non-pharmacological intervention. The patient was a 76-year-old woman residing at the Tresna Werdha Social Care Facility in Jember, presenting with instability during standing and walking and a history of near-fall episodes. Initial assessment showed a high fall risk, with a Timed Up and Go Test (TUGT) time of approximately 71 seconds and a Morse Fall Scale score of 55. ROM exercises were performed in an active manner on the upper and lower extremities once daily for approximately 15–30 minutes over six consecutive days. Evaluation was conducted by measuring the Timed Up and Go Test (TUGT), Morse Fall Scale (MFS), blood pressure, and the client’s subjective responses before and after the intervention. The results showed a gradual reduction in TUGT duration over the intervention period, indicating improvement in mobility and movement coordination, although the TUGT values remained within the high fall risk category. The MFS score remained in the high-risk category, which may be influenced by the client’s baseline condition and the relatively short duration of the intervention. Blood pressure measurements demonstrated a decreasing trend, although they had not yet reached normal levels. Subjectively, the client reported increased confidence and improved stability when standing and walking. In conclusion, Range of Motion exercises demonstrated positive early effects on improving mobility and stability in older adults with hypertension. However, continuous and long-term implementation is required to achieve a significant reduction in fall risk categories.