CAD/Angina Flashcards
the build up of atherosclerosis in the arteries that are feeding blood and oxygen to the heart =
CAD
3 acute coronary syndromes
Unstable Angina
Non-ST Elevation Myocardial Infarction (Non-STEMI)
ST-Elevation Myocardial Infarction (STEMI)
CAD divided into 2 main categories
- stable angina
- acute coronary syndrome
ischemia vs infarction
ISCHEMIA=If oxygen supply does not meet the demands of heart
—>prolonged ischemia leads to cell/tissue death no matter what kind of cell it is
INFARCTION = Obstruction of the blood supply to an organ or region of tissue, typically by a thrombus or embolus, causing local DEATH of the tissue
Chest PAIN that occurs when the heart’s demand for O2 exceeds the coronary arteries’ ability to supply O2
Angina
why does angina hurt?
build up of lactic acid due to anaerobic metabolism
who has atypical chest pain
women
what causes chronic stable angina
build up of stable plaque narrowing vessel and is medically managed
When does chronic stable angina occur?
- Occurs with activity –>increase demand for O2 but can’t meet the demand
- Pattern of occurrence
this type of angina is associated with stable plaque
chronic stable angina
stable angina is usually relieved by….
nitroglycerin and rest (within 15 minutes)
During stable angina do we have ischemia or infarction? perm damage?
ischemia = lack of O2
Does not cause permanent damage to heart tissue: only ischemia not infarction
if someone is having chest pain for the first time is it stable or unstable?
consider it unstable until they have a diagnosis of stable
stable angina + illness/sepsis =
unstable angina!
turns your stable until unstable angina
when do we call for help with stable angina?
-doesn’t follow normal pattern, nitro isn’t helping, resting isn’t helping
angina that Occurs at rest or with exertion
unstable angina
characteristics of unstable angina (4)*
- Occurs at rest or with exertion
- Unpredictable
- Not relieved by nitroglycerin or rest
- Lasts longer than 15 minutes
angina driven by unstable plaque
unstable angina
MONA for acute chest pain
-MONA- morphine, oxygen, nitroglycerin, aspirin
Assessment and interventions for chest pain
- ECG and Vital Signs
- Telemetry
- Pain assessment
- OLDCART
- Oxygen therapy if needed
- IV Access
- Nitroglycerin
- MONA- morphine, oxygen, nitroglycerin, aspirin
what test will distinguish b/w acute coronary syndrome and stable angina
12 lead ecg
if someone ECG is normal now, then you are done.
True or false
FALSE.
- repeat frequently - if tissue not dead now, could be dead soon
- –>changes in conduction due to cell death are what we are checking for
BP with chronic or unstable angina
can be anything!
- high = contributing or trying to get output
- low = can’t give morphine/nitro b/c they reduce afterload
