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Angina pectoris
1.
2. Angina pectoris is the
medical term for chest
pain or discomfort
Cause:insufficient
blood flow
Angina is a symptom
of a condition called
myocardial ischemia
Artherosclerosis,
Coronary artery
disease are the main
causes of angina
7. Angina is a sign that someone is at
increased risk of heart attack, cardiac
arrest and sudden cardiac death.
It may occur in the absence of a significant
disease of the coronary arteries as a result
of coronary spasm, stenosis or insufficiency
and etc.
8. There is a weak relationship between pain and
oxygen deprivation in the heart muscle
TRUE!!!!!
“there can be severe pain with little or no
risk of a heart attack, and a heart attack
can occur without pain”
9.
10. 2.Unstable angina
1. Stable angina preinfarction angina
symptoms occur frequently
chronic stable and last longer
angina pain is lower, and may occur
at rest
have episodes of
It has at least one of these
chest discomfort three features:
that are usually usually lasting >10 min;
predictable it is severe and of new onset
They occur on (i.e., within the prior 4–6
weeks); and/or
exertion or stress. it occurs with a crescendo
pattern (i.e., distinctly more
severe, prolonged, or frequent
than previously).
are not relieved by rest and
NGT tab.
11.
12. 3. Intractable or refractory angina
severe incapacitating chest pain
4. Variant angina
also called Prinzmetal’s angina
pain at rest with reversible ST-segment elevation
It usually occurs spontaneously
it nearly always occurs when a person is at rest.
It doesn't follow physical exertion or emotional stress,
either.
Attacks can be very painful and usually occur between
midnight and 8 a.m
5. Silent ishemia
objective evidence of ishemia(such as ECG changes with
a stress test), but patient reports no symptoms.
13. cigarette smoking
diabetes
high cholesterol
high blood pressure
sedentary lifestyle
family hx. of premature heart disease
Kidney disease
14. may produce pain varying in severity from mild
indigestion to a choking ► heavy sensation in the upper
chest that ranges from discomfort to agonizing pain
accompanied by severe apprehension and a feeling of
impending death
The patient with DM may not experience pain
The pain is retrosternal
the pain is poorly localized and may radiate to the neck,
jaw, and shoulders, and inner aspects of the upper
arms, usually the left arm.
15. woman may have different symptoms than man
weakness or numbness in the arms, wrists and
hands, as well SOB, pallor, diaphoresis,
dizziness or lightheadedness and nausea and
vomiting may accompany the pain
atypical symptoms, including breathlessness,
nausea, or epigastric discomfort or burping.
(women)
It is exacerbated by having a full stomach and
by cold temperatures
it subsides with rest or nitroglycerin
16. Suspect angina:
people presenting with tight, dull, or heavy
chest discomfort :
Retrosternal or left-sided
radiating to the left arm, neck, jaw, or back
Associated with exertion or emotional stress
and relieved within several minutes by rest
Precipitated by cold weather or a meal.
19. Elderly persons with angina may not exhibit
the typical pain profile because of the
diminished responses of neurotransmitters
that occur with aging, often the presenting
symptoms in the elderly is dyspnea. If pain
occurs it radiates to both arm not only in left
arm, some times there is no symptoms
20. OXYGEN DEMAND OXYGEN
SUPPLY
are met through pharmacologic therapy and
control of risk factors
Reperfusion procedures may be used to
restore the blood supply to the myocardium.
These includes PCI
procedures(percutaneous transluminal
coronary angioplasty [PTCA], intracoronary
stents and atherectomy and CABG
21. Stop smoking
Cut down on fatty foods, especially high fat foods if
you have high blood cholesterol levels
Increase your level of exercise
Eat more oats, which have been shown to reduce
cholesterol
Lose weight if your doctor thinks you are
overweight
Make sure your blood pressure is not high by
having regular check ups
Consider another method of contraception if you
take the Pill
25. stop all activities
sit or rest in a bed in a semi-Fowler’s
alternate rest and activity periods.
Assess pain and vital signs, noting respiratory
distress, ans ST segment on ECG.
Administer nitroglycerin(up to 3 doses) and
oxygen.
stress reduction methods with patient(eg, music
therapy)
26. Stop smoking
Cut down on fatty foods, especially high fat
foods if you have high blood cholesterol
levels
Eat more oats, which have been shown to
reduce cholesterol
Lose weight if your doctor thinks you are
overweight
Make sure your blood pressure is not high by
having regular check ups