Angina & MI

Question 1

What is angina?

Answer 1

The constriction of the coronary arteries, caused by atherosclerosis (fatty, fibrous, plaques narrowing the artery).

Presents with central chest pain, sometimes radiating to the jaw or arms, primarily the left arm.

Myocardial ischemia, or temporary or partial block of the artery.

Question 2

What is stable angina?

Answer 2

Angina that may come on with exertion but that abates when the pt stops exerting themselves, or on use of the pt’s GTN. Predictable in nature and so therefore usually manageable.

Question 3

What is unstable angina?

Answer 3

Angina that has lost the predictability of its presentation. For example, it may come on on exertion but may not go away or abate when the exertion stops or the pt takes their GTN. Consider MI.

Question 4

How do you manage stable angina?

Answer 4

Rest, GTN. Precautionary ECG. Consider aspirin.

Question 5

How do you manage unstable angina?

Answer 5

Rest, GTN, apirin, consider MI and MI protocols

Question 6

What is an MI?

Answer 6

Myocardial infarction. Death of the myocardium through depleted oxygenation. A complete block of the artery with a clot forming or formed behind the atherosclerosis.

Question 7

How do you manage an MI?

Answer 7

Aspirin. ECG. GTN (with systolic BP over 90), pain relief. Pre-alert the hospital and convey to cath lab for possible percutaneous coronary intervention.

Question 8

Signs and symptoms of MI

Answer 8

Cold, clammy. Low, normal, or high BP. Crushing central chest pain that may radiate to the jaw, shoulder, left (or right arm), or upper back. Abdo pain possible in women. Vomiting (more common in women). Rapid heart rate. SOB.