Angina

Question 1

Chronic stable angina onset

Answer 1

Physical exertion
Stress
Emotional upset

Question 2

Chronic stable angina duration of pain

Answer 2

few minutes

Question 3

Chronic stable angina precipitating factors

Answer 3

PE exertion
Temperature extremes
Strong emotions
Consumption of heavy meal
Tobacco use
Sexual activity
Stimulants

Question 4

risk factors for chronic angina

Answer 4

a. Males
b. Sedentary lifestyles
c. HTN, Tobacco use, Hyperlipidemia, Obesity
d. Excessive alcohol
e. Stress
f. Diabetes
g. Elderly and Age

Question 5

treatment of chronic angina

Answer 5

i. Rest, calm down, sublingual nitroglycerin (SL NTG)

ii. Generally predictable and controlled with drugs

Question 6

Associated with diabetic neuropathy

Answer 6

silent ischemia

Question 7

increases with occurrence, severity, and duration over time at rest or with exercise

Answer 7

Unstable & prinzmetals (variant) Angina

Question 8

contributing factors for unstable & prinzmetal (variant) angina

Answer 8

increased levels of certain substances, narrowed blood vessels from medications, or exposure to cold weather

Question 9

unstable & prinzmetal (variant) angina treatment

Answer 9

Moderate exercise, SL NTG, calcium channel blockers, stop offending substance; may resolve on own

Question 10

Goal of care for chronic stable angina

Answer 10

Reduce O2 demand and/or increase O2 supply

Question 11

Diagnostic studies for chronic angina

Answer 11

12-lead ECG
Echo
labs: cardiac biomarkers, lipid profile, CRP

Question 12

Lab blood work: chronic angina

Answer 12

Troponin

Rises within 4-6 hrs
peak: 10-24 hrs
detected up to 10-14 days

Question 13

Lab blood work: chronic angina

Answer 13

Creatine kinase (CK)
Rise: 3-6 hrs
Peaks: 12-24 hrs
Baseline: 12-48 hrs

Question 14

Lab blood work: chronic angina

Answer 14

Myoglobin

released in 2hrs

Question 15

Marker for inflammation

Answer 15

C-Reactive protein

Question 16

Elevated levels increased risk for CAD, peripheral vascular disease (PVD), and stroke

Answer 16

Homocysteine (Risk prevention)

Question 17

triglyceride numbers

Answer 17

1. Male: 40-160 range

2. Female: 35-135 range

Question 18

Cholesterol studies

Answer 18

1. Under 200
2. LDL: under 130
3. HDL: male >45, Female >55

Question 19

Echocardiogram normal ejection fraction

Answer 19

60-70%

Question 20

Gold standard for blockage:

Answer 20

Stress test, cardiac cath

Question 21

Acute care for angina patients

Answer 21

i. Position upright; apply oxygen
ii. Assess: VS; heart, and breath sounds
iii. Continuous ECG monitor; 12-lead ECG
iv. Pain relief—NTG; IV opioid if needed
v. Obtain cardiac biomarkers
vi. Obtain chest x-ray
vii. Provide support; reduce anxiety

Question 22

Sublingual nitroglycerin how too

Answer 22

i. Give 1 tablet or 1 to 2 metered sprays
ii. Relief in 5 minutes; duration 30 to 40 minutes
iii. May repeat every 5 minutes × 3 doses
iv. If no relief, call EMS

Question 23

when you have chest p!

Answer 23

1. STOP what they are doing
2. Take nitroglycerin
3. If they don’t get relief-call EMS
4. Give report of what happened

Question 24

Diet

Answer 24

resting after meals