Angina Pectoris Demo

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ANGINA PECTORIS



1. To review the anatomy and physiology of the

cardiovascular system.

2. To define angina pectoris and its clinical

manifestations.3. To discuss the factors that evoke chest pain.

4. To explain the pathophysiology of angina

pectoris.

5. To determine the different types of angina.

6. To ascertain the different diagnosticexaminations.

7. To be able to understand the different medical

and nursing management.



CLASS EVOKING ACTIVITY LIMITS TO

ACTIVITY

I Prolonged exertion None

II Walking >2 blocks Slight

III Walking <2 blocks Marked

IV Minimal or rest Severe



FACTORS THAT EVOKE

TYPICAL CHEST PAIN

Physical Exertion

Exposure to cold

Eating a heavy meal

Stress or any emotion-provoking situation



PATHOPHYSIOLOG Y

CAUSES

INC. M YOCARDIAL

OXYGEN DEMAND

TEMPORARY

CESSATION

LACTIC ACID

PRODUCTIONCHEST PAIN



CLINICAL MANIFESTATIONS

o Chest pain

Retrosternal pain

Compressing, burning, squeezing, crushing heaviness

Radiates to left arm, jaw, neck, and back

5-10 minutes

o Feeling of indigestion to a choking

o Numbness o Severe apprehension

o Feeling of impending death

o May accompany diaphoresis, pallor, dizziness or

lightheadedness, and NV



CLINICAL MANIFESTATIONS

o Be alert to those patients who are:

Diabetic (Diabetes mellitus Elderly patients

o May be relieved by rest and NTG



TYPES OF ANGINA

1. STABLE ANGINA

Identifiable cause of pain (exertion)

Predictable Relieved by rest

2. UNSTABLE

Pain lasts longer than stable May occur at rest



TYPES OF ANGINA

3. VARIANT/PRINZMETAL ANGINA

CAUSE: vasospasm

Pain at rest

4. SILENT ISCHEMIA

No symptoms

Ob jective evidence of ischemia



DIAGNOSTICS

11. Clinical manifestations

2. Echocardiogram

3. ECG

4. Stress test

5. Cardiac enzymes



MEDICAL MANAGEMENT

GOAL:

q the myocardial oxygen demand

o oxygen supply



PHARMACOLOGICAL

THERAPHY

1. NITROGL YCERIN (Nitrostat, Nitrol, Nitrobid IV)

Mainstay for treating angina pectoris

Dilates veins (higher doses, arteries) ± decreasepreload

Prevent vasospasm and increase perfusion

through the collateral vessels

SL or spray, topical agent, and IV S/E: HPO (and other accompanied signs of it)



PHARMACOLOGICAL

THERAPHY

2. BETA-ADRENERGIC BLOCKING AGENTS (-olol)

Blocks the beta-adrenergic receptors in the

heart S /E: HPO, bradycardia, AV block, and heart

failure

C /I: asthma

Instruct patient not to stop abruptly but decrease gradually



PHARMACOLOGICAL

THERAPHY

4. ANTIPLATELET (Aspirin, Clopidogrel)

Prevents platelet activation and reduces the

incidence of MI Given immediately once angina is diagnosed

If concurrently under NSAIDs, patient may be

treated with H2 blockers.

S /E: Bleeding



PHARMACOLOGICAL

THERAPHY

5. OXYGEN ADMINISTRATION

Given immediately

O2 saturation and respiratory rate and rhythm



NURSING MANAGEMENT

1. Assess pain or other signs and symptomsusing the PQRST format.

2. If patient reports pain, instruct patient, place

patient in SEMI-FOWLER¶S POSITION.

3. Measure vital signs.

4. 12-Lead ECG

5. NTG. Assess pain and vital signs.

6. Oxygen administration. 2 L /M.



NURSING MANAGEMENT

1. Providing information about the illness, itstreatment, and methods of preventing its

progression.

2. Stress reduction (music therapy,

aromatherapy, etc.)

3. Addressing the spiritual needs of the patient

and family



NURSING MANAGEMENT

1. Identify the level of activity that causes pain.2. Plan the patient¶s activities

3. May alternate patient¶s activities with rest

periods.

4. Balance of activity and rest.

Angina Pectoris Demo

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