Angina Flashcards
What is atherosclerosis?
Endothelial lining of arteries reacts to HTN and high cholesterol by inflammation. Platelets are activated and macrophage infiltration causes uptake of lipids. This causes blockages
Is arterial blood flow under high or low pressure?
Higher than the venous system
What does the aorta do in relation to blood flow?
Regulates coronary artery blood flow and supply
Modifiable risk factors for CAD?
Elevated lipids, HTN, cig smoking, diabetes type 2, stress, physical inactivity, and obesity.
Non modifiable risk factors CAD?
Gender (men>women until 65 yrs), Diabetes types 1, increasing age, genetic predisposition, family redisposition, and ethnicity.
Psychological risk factors for CAD?
Depression, anger, stress, and hostility.
Symptoms of angina?
Usually chest pain (described as burning, crushing chest pain, pressure can go down into shoulder and left arm). Can also be described as indigestion or tooth ache
What is angina?
Pain causes by imbalance between O2 supply and the cardiac muscle demand for it. There’s not enough O2 getting to the cells and it causes ischemia.
Stable and unstable angina?
Stable- chest pain after exertion that resolves with rest/nitro within 5 min, it’s familiar/unchanged
Unstable- episode of chest pain that doesn’t resolve within 5 minutes, poorly relieved by nitro/rest and pressure may last longer than 15 min, occurs at rest/with exertion, its a new onset,
What can angina be a precursor to?
MI
What are the focused nursing assessments for angina?
CVS and PVS. Auscultate heart, skin colour (ashy or blue colour), edema, peripheral pulses, signs of HF.
What is cardiac blood work?
Let’s you know serum cardiac markers (proteins release into blood when there’s necrosis and damage to the myocardium). CKs indicate cardiac muscle damage.
Dx and labs for angina?
Cardiac blood work, ECG, ASA, O2 therapy, nitroglycerin
ECG for angina?
Obtain a 12 lead ECG within 10 minutes of pt reporting chest pain. This will identify QRS or ST abnormalities and is the easiest way to rule out an MI.
Pharmacological management for angina?
Give aspirin initially to reduce thrombus formation (162-325 mg). Nitroglycerin is a coronary vasodilator and works fast to relieve chest pain. Give morphine if nitro doesn’t work/pain persists because it reduces pain and has some coronary vasodilation properties. Also can give platelet inhibitors.
What do beta blockers and ace inhibitors do?
BB- slow HR and increase CO
AI- vasodilator, decrease amount of effort the heart needs to use
Exercise stress test?
Common dx test that combines exercise (treadmill) and ECG monitoring to evaluate myocardial tissue perfusion. Positive stress test means there’s a positive result (mismatch between O2 demand and perfusion rates).
What does thrombotic therapy do?
Medication will break up clots and open blood vessels. Need to monitor for bleeding.
What is a coronary artery stent?
Put a stent where the blockages are, expand the balloon and it keeps the artery open.
Pt education for angina?
Have a good diet (low fat intake), increase omega 3 fatty acids, smoking cessation, decrease nicotine use
What is CAD?
Broad term that includes chronic stable angina and ACS. It affects arteries that provides blood and O2 to myocardium. Ischemia and infarction can occur
What is ischemia and infarction?
- There’s insufficient O2 supplied to meet requirements of myocardium
- Also known as cell death, occurs when severe ischemia is prolonged and decreased perfusion causes irreversible damage to tissue
What is acute coronary syndrome (ACS)?
Patients who have unstable angina or acute MI. The atherosclerosis plaque in coronary artery ruptures which causes clot formation and blood flow is impaired
What is vasospatic angina?
Chest pain resulting from coronary artery spasms and usually occurs after rest
