ANGINA PECTORIS




                                    ANGINA PECTORIS


Angina pectoris is a pain in the chest caused by myocardial ischemia .
Ischemia means deficiency of blood supply to the myocardium.



ETIOLOGY
§  Blockage or narrowing of a coronary artery
§  Cigarette smoking
§  Exposure to cold or heat
§  Myocardial ischemia
§  Lack of oxygen

CLINICAL MANIFESTATION

§  Chest pain
§  Tachycardia
§  Increased or decreased blood pressure
§  Dyspnea
§  Nausea
§  Vomiting
§  The pain lasts for 5 to 10 minutes

TYPES OF ANGINA




There are 7 types
1.stable angina :
 It is characterized  by pain and discomfort caused by emotions,physical exertion etc.
2.Unstable angina :
 It occurs mostly in night ,pain more than 20 minutes can relived by medical treatment
3. variant angina :
 Pain takes more longer time . it may can occur when patient take rest also.
4. Noctural angina :
It assosciated with rapid eye movement sleep during dreaming .
5. Angina decubitus :
 Pain occur when patient sits or stand up.
6.Intractable angina :
It is a chronic pain in the chest .
7.Post infraction angina :
 It occur the pain after myocardial infarction .

DIAGNOSTIC EVALUATION
o   Chest X-ray
o   ECG
o   Tread mill test
o   Echocardiography
o   Increased creative protein (CRP)

MEDICAL MANAGEMENT
·         Nitrates this help to relive pain such as nitroglycerine tablets
·         Antianginal help to relieve pain and discomfort . example Beta blockers
·         Calcium channel blockers it prevents vasodilation of coronary arteries . Example : diltiazem ,folodipine .
·         Morphine it acts as an analgesic and sadatives .
·         Anti platelet therapy it helps to reduce the coronary artery disease and clot formation.
·         Aspirin helps to promote normal blood flow
·         Oxygen supply
SURGICAL MANAGEMENT :
ü  LASER ANGIOPLASTY
                It is performed with a catheter containing fibers that carry laser energy. This laser energy used to dissolve the blockage in the coronary artery.
NURSING MANAGEMENT :
v  Cardiac monitoring with 12 leads ECG.
v  Assess the level  duration of pain
v  Assess signs and symptoms
v  Check the vital signs
v  Advice the patient to do some exercises
v  Advice the patient to have small and frequent meals
v  Advice the patient to stop smoking
v  Advice the patient to take rest after meal
v  Advice the patient to take food high in fiber because it prevents the constipation .

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