Coronary Vascular Disorders

Question 1

Coronary Artery Disease (CAD) definition

Answer 1

Abnormal accumulation of lipid/ fatty substances in the lining of coronary vessels (atherosclerosis)
–> reduce blood flow to myocardium
–> ischemia –> myocardial infarction

Question 2

Causes of CAD

Answer 2

• Atherosclerosis
• vasospasm of coronary artery
• myocardial trauma from internal (bubble, blood clots)/ external (pneumothorax) forces
• congenital anomalies
• decrease O2 supply (anemia, acute blood loss, hypotension)

Question 3

Name the chest pain brought about by myocardial ischemia

Answer 3

Angina pectoris

Question 4

4 types of angina

Answer 4

Stable; Unstable; Variant; Silent

Question 5

Define stable & unstable angina

Answer 5

Stable: predictable & consistent pain; occurs on exertion and relieved by rest
Unstable: more frequent, lasts longer. Threshold for pain is lower and may occur at rest

Question 6

Define variant & silent angina

Answer 6

Variant: pain at rest w. reversible ST elevation; caused by coronary artery vasospasm
silent: objective evidence of ischemia eg ECG changes but pt reports no symptoms

Question 7

Clinical manifestations of angina

Answer 7

poorly located pain, felt deep in the chest behind sternum;
may radiate to neck, shoulders, maybe left arm, tightness, heavy & choking sensation

Question 8

Immediate general treatment for angina

Answer 8

MONA
Morphine
O2 administration
Nitroglycerin (sublingual/ spray)
Aspirin 160-325mg

Question 9

Nursing interventions for angina

Answer 9

• Sit/ rest in bed, reduce O2 consumption
• obtain ECG, scrutinize for ST segment & wave changes
• provide info abt illness, Tx & prevention methods
• Music therapy; relieve stress
• MONA