Angina

What Is Angina?
A term used for chest pain caused
by reduced blood flow to the heart
muscle.
Typically described as squeezing,
pressure, heaviness, tightness or
pain in your chest.
Symptom of coronary artery
disease
also called Angina Pectoris

Types of Angina
Stable Angina
Unstable Angina
Variant (Prinzmetal's)
Angina

Characteristics of stable angina

Develops when your heart works
harder
Can usually be predicted and the
pain is usually similar to previous
types of chest pain you've had
Lasts a short time
Disappears sooner

haracteristics of unstable angina

Is usually more severe
and lasts longer than
Is a change in your usual stable angina
pattern of angina
May not disappear with
Is unexpected
rest or use of angina
medication
Occurs even at rest

Might signal a heart

attack

Cause
s

 Angina is caused by
reduced blood flow to your
heart muscle
When your heart muscle
isn't getting enough
oxygen, it causes a
condition called ischemia.

Tobacco Use

Diabetes

High blood pressure

High blood cholesterol or

triglyceride levels

History of
heart disease

Older age

Lack of exercise

Obesity

Stress

Illegal drug use

Signs and Symptom

Chest pain or discomfo

Pain in your arms, neck, jaw,

shoulder or back
accompanying chest pain

Nausea

Fatigue

Shortness of Breath

Sweating

Dizziness

Tests and diagnosis

Electrocardiogram
(ECG or EKG).

Chest X-ray
Blood tests

Stress test
Coronary angiography
Echocardiogram
Nuclear stress test

Cardiac computerized
tomography (CT) scan

Tests and diagnosis

Electrocardiogram
(ECG or EKG).

Chest X-ray
Blood tests

Stress test
Coronary angiography
Echocardiogram
Nuclear stress test

Cardiac computerized
tomography (CT) scan

Tests and diagnosis

Electrocardiogram
(ECG or EKG).

Chest X-ray
Blood tests

Stress test
Coronary angiography
Echocardiogram
Nuclear stress test

Cardiac computerized
tomography (CT) scan

Tests and diagnosis

Electrocardiogram
(ECG or EKG).

Chest X-ray
Blood tests

Stress test
Coronary angiography
Echocardiogram
Nuclear stress test

Cardiac computerized
tomography (CT) scan

Tests and diagnosis

Electrocardiogram
(ECG or EKG).

Chest X-ray
Blood tests

Stress test
Coronary angiography
Echocardiogram
Nuclear stress test

Cardiac computerized
tomography (CT) scan

Tests and diagnosis

Electrocardiogram
(ECG or EKG).

Chest X-ray
Blood tests

Stress test
Coronary angiography
Echocardiogram
Nuclear stress test

Cardiac computerized
tomography (CT) scan

Tests and diagnosis

Electrocardiogram
(ECG or EKG).

Chest X-ray
Blood tests

Stress test
Coronary angiography
Echocardiogram
Nuclear stress test

Cardiac computerized
tomography (CT) scan

Tests and diagnosis

Electrocardiogram
(ECG or EKG).

Chest X-ray
Blood tests

Stress test
Coronary angiography
Echocardiogram
Nuclear stress test

Cardiac computerized
tomography (CT) scan

Treatments and Drugs

Medications

Nitrates
Aspirin
Clot-preventing drugs
Beta blockers
Statins
Calcium channel blockers
Ranolazine (Ranexa)

Medical procedures and surge

Angioplasty and stenting
Coronary artery bypass surgery

Heart Attack!!

Nursing Management
Instruct patient to notify nurse
immediately when chest pain
occurs.
Take immediate action if patient
reports pain or if thepersons
prodromal symptoms suggest
anginal ischemia
Direct the patient to stop all
activities and sit or rest inbed in
a semi Fowlers position to reduce
the oxygenrequirements of the
ischemic myocardium.
Measure vital signs and observe
for signs of respiratory distress.
Administer nitroglycerin

 If the patient has pain frequently or

with minimal activity, alternate the
patients activities with rest periods.
Balancing activity and rest is an
important aspect of the educational
plan for the patient and family.
Encourage avoidance of situations
that may precipitate anginal episode
(stress, intense physical exertion,
large heavy meals especially during
bedtime, exposure to extreme
temperatures).
Discuss impact of illness on desired
lifestyle and activities, including
work, driving, sexual activity, and
hobbies. Provide information,
privacy, or consultation, as
indicated.

 Quitting smoking
Monitoring and controlling other health
conditions, such as high blood pressure,
high cholesterol and diabetes
Eating a healthy diet
Increasing your physical activity after
you get your doctor's OK
Maintaining a healthy weight
Reducing your stress level

Myocardial Infarction

What is Myocardial
Infarction?
commonly known as aheart
attack
occurs when the flow of
blood to the heart is blocked
most often by a build-up of
fat, cholesterol and other
substances
Most MIs occur due
tocoronary artery disease

Caus
occurs when one or more of
es arteries become
your coronary
blocked
spasm of a coronary artery that
shuts down blood flow to part
of the heart muscle
A heart attack can also occur
due to a tear in the heart artery

Tests and diagnosis

Electrocardiogram (ECG)
Blood tests
Chest X-ray
Echocardiogram
Coronary catheterization (angiogram)
Exercise stress test
Cardiac computerized tomography (CT)
or magnetic resonance imaging (MRI).

Treatments and drugs

Medications
Aspirin

Surgical and other procedures

Thrombolytics

Coronary angioplasty and stenting

Antiplatelet agents

Coronary artery bypass surgery

Other blood-thinning
medications
Pain relievers
Nitroglycerin
Beta blockers
ACE inhibitors

 Abnormal heart rhythms (arrhythmias)

Heart failure
Heart rupture
Valve problems

Pathophysiology

Nursing Management
Administer analgesics as
ordered.
Organize patient care and
activities to allow periods of
uninterrupted rest.
Provide aclear liquid dietuntil
nausea subsides.
Provide stool softener to
prevent straining during
defecation.
Assist with range of motion

 Assess andrecordthe patients

severity, location, type, and
duration of pain.
Encourage discussion about post
discharge expectations.
Emphasize importance of
contacting physician if chest
pain, change in anginal pattern,
or other symptoms recur.
Thoroughly explain the
medication and treatment
regimen.
Review dietary restriction with

 Medications
Lifestyle
factors