Exam 1: Chapter 31 - Angina and Myocardial Infarction Flashcards
When does ischemia cause chest pain?
When blood flow to the heart is compromised
What differentiates stable angina from an mi
An mi is pain unrelieved by rest or nitroglycerin and lasts more than 15 minutes
What are health promotion and disease prevention steps for angina and mi
- Maintain an exercise routine
- have cholesterol and Blood pressure checked regularly
- consume a diet low in saturated fats and low in sodium
- stop smoking
what is stable (exectional) angina?
Angina that occurs with exercise or emotional stress and is relieved by rest or nitroglycerin
What is unstable (preinfanction) angina?
Angina that occurs with exercise or at rest, but increases in occurrence, severity, and duration overtime
What is variant (prinzmetals) angina?
Angina due to a coronary artery spasm, often occurring during rest periods
What is being a male or mostpenopausal put the client at greatest risk for?
Angina
What are the possible areas of referred pain in angina?
Jaw, chest, shoulders, neck, arms
What are expected reported findings by the patient with angina?
- Anxiety, feeling of impeding doom
- chest pain
- nausea
- dizziness
- a typical angina in females
What are physical expected findings in patients with angina?
- Pall’r, cool, clammy skin
- decreased level of consciousness
- tachycardia and heart palpitations
- tachypnea and shortness of breath
- diaphoresis
- vomiting
What are cardiac enzymes released with injury to cardiac muscle?
- Myoglobin
- creatine kinase-MB
- troponin t or i
What is the earliest marker of injury to cardiac or skeletal muscle and which levers are no longer evident after 24 hours?
Myoglobin
What enzyme peaks around 24 hours after onset of rest pain and which levels are no longer evident after 3 days?
Creatine kinase-mb
What enzyme which if ever snows positive in theblood indicates damage to cardiac tissue
And should be reported?
Troponin t or I
Which enzyme’s levels are no longer evident after 7-10 days?
Troponin I
Which enzyme’s levels are no longer evident after 10-14 days?
- troponin T
What shows in an electrocardiography in angina?
ST depression, and/or t-wave inversion indicates presence of ischemia
What shows in an electrocardiography for someone with an MI
T - wave inversion indicates ischemia, ST - segment elevation indicates injury, abnormal Q-wave indicates necrosis
What does a thallium scan assess for?
Ischemic and necrosis
What client education stand be provided prior to a thallium scan?
Avoid smoking and consuming caffeinated beverages 4 hours prior to procedure
What client education stand be provided prior to a cardiac catheterization?
-Npo for 8 hours prior to procedure
- assess for iodine/sherifion allergy
What is the difference between a STEMI MI vs NSTEMI MI
ST is elevated in STEMI and is not in NSTEMI
What medications are used for angina and an mi
- Vasodilators (nitroglycerin)
- analgesics (morphine)
- beta-blockers (metoprolol)
- thrombolytic agents (alteplase)
- antiplatelet agents (aspirin)
- anticoagulants (heparin)
- glycoprotein IIB/IIIA inhibitors (eptifibatide)
What is an acute mi a complication for?
Angina not relieved by nest or nitrogrocerin
What can injury to the left ventricle following an mi of 40% blockage cause?
Decreased cardiac output and heart failure. Progressive near failure can lead to cardiogenic shock
What complication can occur ave to necrosis from mi
Ventricular aneurysm s/rupture
What are symptoms of ventricular aneurysms / rupture
Sudden chest pain, dysrythmias, serene hypotension
