Cardiac Cases

Question 1

Define angina pectoris

Answer 1

Chest pain that results when the blood supply’s oxygen demands exceed the heart’s

Question 2

What is Prinzmetal’s angina

Answer 2

Variant of angina pectoris caused by vasospasm of the coronary arteries, not a blockage per se.

Also called:

• vasospastic angina
• atypical angina

Question 3

Define stable angina

Answer 3

Stable angina occurs during activity, when the heart’s oxygen demands are increased. Attacks of stable angina are typically precipitated by physical or emotional stress.

Question 4

Define unstable angina

Answer 4

Unstable angina occurs at rest and may not respond as readily to treatment.

Question 5

What typically causes reduced blood flow through coronary arteries.

Answer 5

Atherosclerosis, a disease in which plaque builds up, narrowing the diameter of the arteries.

Question 6

List three cardiovascular causes of chest pain.

Answer 6

• Cardiac ischemia
• Pericarditis
• Thoracic dissection of the aorta

Question 7

What are the key features of stable angina

Answer 7

Symptoms

• chest pain or discomfort that feels:
  
  • tightness
  • squeezing
  • heavy pressure
  • crushing feeling
• pain that radiates to the:
  
  • arm (most often the left)
  • back
  • jaw
  • neck
  • shoulder
• nausea
• shortness of breath
• fatigue
• dizziness
• anxiety

Signs

• weak / absent radial pulses
• pale / cyanosed skin color
• cold extremities
• sweating

Vital signs

• tachycardic
• tachypneic
• normo/hypertensive
• pulse may be irregular
• equal peripheral pulses
• normal or slightly low Sp02
• S-T depression and/or T-wave inversion

Question 8

What are the key features of Myocardial infarction

Answer 8

Symptoms

• chest pain or discomfort that feels:
  
  • tightness
  • squeezing
  • heavy pressure
  • crushing feeling
• pain that radiates to the:
  
  • arm (most often the left)
  • back
  • jaw
  • neck
  • shoulder
• chest pain is usually acute, severe, constant, and unrelenting
• chest paint that lasts >30 minutes
• pain that is rated >8
• nausea/vomiting
• shortness of breath
• fatigue
• dizziness
• impending sense of doom

Signs

• weak / absent radial pulses
• pale / cyanosed skin color
• cold extremities
• profuse sweating

Vital Signs

• hypertension during MI episode
• equal peripheral pulses
• tachycardic
• tachypneic
• S-T depression
• Q wave deeper than 5mm and/or wider than 0.4 seconds may indicate infarcted tissue.

Question 9

How long does angina usually last

Answer 9

1 - 15 minutes.