ANGINA PECTORIS

Rozelle Mae Birador

ANGINA PECTORIS

It is a clinical syndrome usually characterized by episodes or paroxysm of pain or pressure in the anterior chest.

Risk factors for angina include:

Physical Exertion

Exposure to cold

Eating heavy meal

Stress or any emotion-provoking situation

Atherosclerotic Disease

TYPES

Stable

• Most common type, precipitated by physical exertion, emotional stress, exposure to hot or cold temperatures, heavy meals, and smoking

• Occurs in a regular pattern, usually lasts 5 minutes or less, and is easily relieved by medications

Unstable

• May be new onset of pain with exertion or at rest, or recent acceleration in severity of pain• Occurs in no regular pattern, usually lasts longer (30 min- utes), not generally relieved with rest or

medications• Sometimes grouped with myocardial infarction (MI) under the diagnosis of acute coronary syndrome

(ACS)

Variant (Prinzmetal’s)

• Rare, usually occurs at rest—midnight to early morning hours• Pain possibly severe• Electrocardiogram (ECG) changes due to coronary artery spasm

CLINICAL MANIFESTATION

Pain

Mild indigestion to a choking

Heavy sensation in the upper chest

Weakness

Numbness in the arms, wrist, and hands

Shortness of Breath

Pallor

Diaphoresis

Dizziness or Lightheadedness

Nausea

Vomiting

Subsides with rest or nitroglycerin

ASSESSMENT AND DIAGNOSTIC• HX- Clinical manifestation of ischemia• 12-Lead Electrocardiogram (ECG)• Cardiac Biomarker• Nuclear Scan (cardiac catheterization,

coronary angiography)

PHARMACOLOGIC THERAPY

NITRATES- Nitroglycerin

BETA- BLOCKERS- Metropolol, Atenolol

CALCIUM CHANNEL BLOCKERS- Amlodipine, Diltiazem

Antiplatelet- Aspirin, Clopidogrel, Prasugrel, Glycoprotein: Abciximab, Eptifibatide

Anticoagulants- Heparin, Low molecular-weight heparins: Enoxaparin, Dalterparin

NURSING DIAGNOSES

Risk for decrease cardiac tissue perfusion

Anxiety related to cardiac symptoms and possible death

Deficient knowledge about the underlying disease and methods for avoiding complications

Noncompliance, ineffective management of therapeutic regimen related to failure to accept necessary lifestyle changes

Collaborative Problems/Potential Complications

• Potential complications of angina include :

ACS and/or MI, dysrhythmias and cardiac arrest, heart failure, and cardiogenic shock.

Nursing Priorities

Relieve/control pain.

Prevent/minimize development of myocardial complications.

Provide information about disease process/prognosis and treatment.

Support patient/SO in initiating necessary lifestyle/behavioral changes.

NURSING INTERVENTIONS

• Encourage to stop all activities and sit or rest in bed in a semi-fowler’s position

• Measuring Vital Signs• Observe for signs of respiratory distress• Administer Nitroglycerin as prescribed• Administer Oxygen therapy if the patient’s

respiratory rate is increased or oxygen saturation is decreased