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 .