ANGINA

transient chest pain casued by insufficient blood flow to the myocardium

resulting in myocardial ischemia

Clinical Manifestations
Pain
transient
heaviness, tightness of the chest “indigestion”
radiates to one or both arms, left shoulder, jaw, neck and back
precipitated by activity or during exertion
relieved by rest and nitroglycerine

pallor
diaphoresis
dyspnea
palpitations
dizziness
digestive disturbances

Types
1. Stable – CP < 15 minutes (T-wave inversion on ECG)
2. Unstable – CP > 15 secs but < 30 minutes (May see ST elevation on
ECG)
recurrence more frequent
often occurs at night
3. Variant (Prinzmetal's) – CP is of longer duration
may occur at rest
often occurs in the early hours of the day
related to CORONARY ARTERT SPASM
4. Intractable Angina – Chronic type
unresponsive to interventions
5. Postinfarction Angina – occurs after MI

Precipitating Events
1. Exertion
2. Emotions
3. Eating
4. Environment

Collaborative Management
1. Vasodilators
- NTG
2. Beta Adrenergic Blocking Agents
- “olols”
 3. Ca Channel Blockers
- Verapamil, Nifedipine, Diltiazem
4. Platelet Aggregation Inhibitors
- ASA
5. Anticoagulants
- Heparin, Warfarin

Nursing Management: Angina

• Maintain cardiac output
• Pain relief
• Self-care; risk-factor modification

Treatment
1. PTCA
- mechanical dilatation of the coronary artery by compressiong the
atheromatous plaque
- recommended for single-vessel CAD
2. Intravascular stenting
- biologic stent is produced (heat, laser or photocoagulation)
- prosthetic intravascular cylindrical stents may be used
3. Laser therapy

Surgical Management
1. CABG
- main purpose is myocardial revascularization
- saphenous vein and internal mammary artery

Nursing Management in CABG

1. Promote Comfort
2. Promote Tissue Perfusion
3. Promote Activity and rest
4. Promote relief of anxiety and feeling of well-being