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25 Cards in this Set
- Front
- Back
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What is angina?
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Chest pain resultingfrom reduced coronary blood flow which causes a temporary imbalance between myocardial blood supply and demand
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What are the 3 types of angina?
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*Stable
*Prinzmetal's (Variant) *Unstable |
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What is stable angina?
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*The most common & predictable form
*Occurs w/a predictable amount of activity/stress *common manifestation of CHD *usually occurs with an increased workload on the heart by physical exertion, exposeure to cold, stress *relieved by rest & nitrates |
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What is Prinzmetal's (variant) angina?
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*Atypical type that occurs unpredictably
*Often at night *unrelated to activity *caused by coronary spasm with or w/o an arthrosclerotic lesion *exact cause unknown but may result from hyperactive SNS responses,altered calcium flow in smooth muscle,reduced prostaglandins that promote vasodilation |
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What do Prostaglandins promote?
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Vasodilation
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What is angina?
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Chest pain resultingfrom reduced coronary blood flow which causes a temporary imbalance between myocardial blood supply and demand
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What are the 3 types of angina?
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*Stable
*Prinzmetal's (Variant) *Unstable |
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What is stable angina?
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*The most common & predictable form
*Occurs w/a predictable amount of activity/stress *common manifestation of CHD *usually occurs with an increased workload on the heart by physical exertion, exposeure to cold, stress *relieved by rest & nitrates |
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What is Prinzmetal's (variant) angina?
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*Atypical type that occurs unpredictably
*Often at night *unrelated to activity *caused by coronary spasm with or w/o an arthrosclerotic lesion *exact cause unknown but may result from hyperactive SNS responses,altered calcium flow in smooth muscle,reduced prostaglandins that promote vasodilation |
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What do Prostaglandins promote?
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Vasodilation
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What is unstable angina?
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*occurs w/increasing frequency,severity,& duration
*Pain unpredictible & occurs w/decreasing levels of activity or stress *may occur at rest *These pts at risk for MI |
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What is Silent Myocardial Ischemia?
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*Asymptomatic Ischemia*
*common in people w/CHD *may occur with either activity or with mental stress *assoc. w/increased chance of MMI and death |
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What is the classic sequence of angina?
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Activity-pain, Rest-relief
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Manifestations of angina?
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*CHEST PAIN*
*described as a tight, squeezing,heavy pressure, or constricting sensation *Dyspnea,pallor,tachycardia, anxiety,fear *Begins beneath the sternum & may radiate to the jaw, neck, shoulder or arm |
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Anginal pain usually occurs in a Crescendo-Decrescendo pattern. What does this mean?
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it increases to a peak then gradually decreases
*usually lasts 2-5 minutes |
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What are the atypical signs of angina commonly presented in women?
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*indigestion/nausea
*vomiting *upper back pain |
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THe severity of angina can be graded by the degree to which
it limits the pts activities. What are these Classes? |
Class I - Doesn't occur w/ordinary physical activity. It's prompted by strenous, rapid, or prolonged exertion
*Class II - May develop w/rapid or prolonged walking or stairclimbing *Class III - Significantly limits ordinary physical activity Calss IV - may have at rest & with physical activity |
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Diagnostic tests used to diagnose angina?
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*ECG (ST segment is depressed or downsloping & T wave may flatten or invert)
*Stress ECG *Radionuclide Testing *Echocardiography (uses ultrasound to evaluate cardiac structure & function *Coronary Angiography (gold standard for evaluating coronary arteries) |
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What is the goal of drug treatment with angina?
What are the 3 main classes of drugs used totreat angina? |
*reduce oxygen demand & increase oxygen supply to the myocardium
*Nitrates, beta-blockers, calcium channel blockers |
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What is the drug of choice to treat acute anginal attacks?
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Sublingual nitroglycerin
*acts within 1-2 minutes |
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What is the drug of choice to treat stable angina?
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Beta-Blockers
*block cardiac stimulating effects of norepinephrine & epinephrine reducing angina by reducing HR,contractility, & BP |
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Wha pts are beta-blockers contraindicated in?
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pts with asthma or severe COPD b/c they may cause severe bronchospasm*
*pts with Prinzmetal's (variant) angina b/c it may make it worse |
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What drug is used for long term angina prophylaxis?
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Calcium channel blockers
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What are common nursing DX for Angina?
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*Ineffective tissue perfusion:Cardiac (from impaired blood flow and oxygen supply to myocardium)
*Risk for Ineffective Therapeutic Regimen Management (pts often in denial) |
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Teaching for pts with angina?
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*CHD & its processes that cause chest pain
*use & desired/adverse effects of medications *NTG use for acute anginal attacks *Seek medical assistance if 3 tabs over a 15-20 min period doesn't relieve the pain *Appropriate storage of NTG *Resp.care,activity,pain management,rehab *manifestations of infection |
