angina pectoris.pdfegakshalslsksjmskskslsl

Disorder

1. ANGINAPECTORIS

2. ◼Itis commonly called“angina”
◼Itis the chest painthatis dueto ischemiaof
theheartmuscle, generallydueto obstruction
or spasm of the coronaryarteries
Definition

3. Themostthreetypesofanginainclude:
Stableangina
Itis triggeredby apredictabledegreeof physicalexertion
ormotionbutcanbeimprovedafterrest.
Itis themostcommontypeofangina
Unstableangina
Itis triggeredby unpredictabledegree whichmayoccurat
night
Itis moredangerousandrequiresemergencytreatment
andis oftenasignthatheartattackcanoccursoon
Variantangina
thisis arareformthatis causedbyaspasmincoronary
artery
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TYPESOFANGINAPECTORIS

4. Anginapectoris is as aresult of ischemiaof
the heartwhichis dueto antherosclerosisof
thecoronaryarteries which restricts blood
flowto themyocardium.
Dueto myocardiumischemia,the myocardial
tissuesaredeprivedof oxygenandnutrients
for the aerobicmetabolism.
Asa resultthere is aninclusionof anaerobic
metabolismwhichleadsto accumulationof
lacticacid
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ETIOLOGYANDPATHOPHYSIOLOGY

5. ◼Dueto increaseof lacticacid, myocardial
nervefibersareirritated andthis transmit
painmessageto the cardiacnervesand
upperthoracic posterior nerveroots
◼Andallthis leadsto cardiacpainwhichis
anginapectoris
a
the

7. ◼Dyspnea
◼Sweating/diaphoresis
◼Faintness
◼Palpitations
◼Dizziness
◼Indigestivedisturbances
CLINICALMANIFESTATION

8. Electrocardiography (ECG)
an ECG recorded in thepresenceof pain may
recordtransient ischemicattacks.
it alsosuggestcoronaryartery’s involvementand
the extentof themyocardiumaffectedby the
ischemicevent
Exerciseelectrocardiography
Thisinvolvesthe client exercisingonatreadmillor
stationerybicycleuntil reaching a maximumof85%
heartrate.
If any change in theECGor vital signs may indicate
the presence of ischemia
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DIAGNOSTIC EVALUATION

9. Radioisotope
thisinvolvesthe useofdifferentnuclearimaging
techniquestoevaluateheartmuscles.
regionsofischemiaappearasareasof
diminishedactivity
Ultrafastcomputedtomography
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itenablesdetectionoftheamountofcalcium
thecoronaryarteries.Highcoronarycalcium
rateisassociatedwithobstructivecoronary
disease.
in-

10. ❑Coronaryangiography
-it detect the percentageof blockagein
coronaryartery
-it remainsthe most accurate test
❑Chestx-ray
-it allowsthe detectionofcardiomegaly
noncardiaccauses ofchest paine.g
pneumonia
and

11. ◼Itfocuses onthree goals
1.Reliefof the acutepain. The majordrugs
usedtoreduceacute painare opioid
analgesicse.g nitroglycerin
2.Restorecoronarybloodflow. Administer
vasodilatorse.g propanolol,calciumchannel
blockerssuch as felodipine.
3.Preventfurtherattacks-this is donethrough
educationandcounselling regarding
modificationof riskfactors of the disease.
MEDICALMANAGEMENT

12. ◼Anginapectoris canlead
• Heartfailure
• Acuterenalfailure
• Myocardialinfarction
• Cardiacarrest
• Death
to:-
ComplicationsofAngina Pectoris

13. BlackJ.M.andHawksJ(2009)Medical–
surgicalNursing,ClinicalManagementfor
1.
(8
th
positiveoutcomes
Elsevier
edition)saunders,
LewisS. M., HeitkemperM.MandDirksen
R(2007)Medical/SurgicalNursing.
Assessmentandmanagementofclinical
S.2.
(7
th
problems. edition)St Louis:C.V. Mosby
http://www.servier.co.uk3.
References