Week 5 - Coronary Heart Disease

Question 1

Acute coronary syndrome - pathophysiology

Answer 1

Plaques can rupture from the side of the artery wall causing blood clots to form. This can partially occlude the artery

Question 2

Symptomology of stable angina

Answer 2

Episodic
Crescendo-decrescendo
Predictable and occurs in response
Duration equal to or less that 10 mins
Pain relieved with anti-angina’s and/or rest

Question 3

ACS symtomology

Answer 3

Severe and new onset
Crescendo pattern
Unpredictable, occurs at rest duration equal to or less than 10th so
May not respond to medication
- requires emergency treatment

Question 4

Pharmacological treatment - angina

Answer 4

Goals
- improve the balance between myocardial oxygen supply and demand
- provide symptom relief
- drug therapy can be used alon or in combination

Treatment of acute e episodes
- short acting nitrates

Treatment to prevent acute episodes
- beta blockers
- non-dihydropyridine calcium channel blockers
- long-acting nitrates

Question 5

Preventing and treating episodes of angina

Answer 5

• offer a shirt-acting nitrate for preventing and treating episodes of angina. Advise people with stable angina
  How to administer the short-acting nitrate
  To use it immediately before any planned exercise or exertion
  That side effects such as flushing, headache and light-headness may occur

Question 6

Nitrate - spray and tablet

Answer 6

Shirt acting administered by sublingual route
Used for acute attacks Tablets have short shelf-life once opened
Spray more economical for less frequent users
Sit or lie down before use - may cause dizziness

Question 7

Nitrates - tablet and patches

Answer 7

Longer acting nitrates used to manage chronic angina
Tolerance to nitrates occurs with continuous exposure
Tablets are controlled-release

Question 8

Nitrates contra-indications/cautions

Answer 8

Pregnancy and lactation