Explain to patient :

1. Rest when pain begins to decrease oxygen demands.

2. Take nitroglycerin when any pain begins-it helps dilate coronary arteries and get
more oxygen to heart muscle.
3. Avoid stress and activities that bring on an angina attack.
4. Call 911 if the pain continues for more than 10 minutes or as the patient is taking
the third nitroglycerine dose (1 sublingual dose every 5 minutes, if BP allows, for
maximun of 3 doses).
5. Stop smoking! Smoking is associated with heart disease
6. Adhere to the prescribed diet and exercise plan. Lower cholesterol and fat intake
to decrease further plaque build-up, and descease excess salt intake to help BP
control. Slowly increase exercise to build up activity tolerance. Possibly exercise
with cardiac rehabilitation.
7. How to recognice the symptoms of a myocardial infarction: Pay attention to chest
pains as well as changes in patterns o pain and respons to treatment. Be aware o
changes in respiratory patterns, increase in shortness of breath, swelling, and
general feelings og malaise.

PATHWAY
 Aterosklerosis
spasme arteri Peningkatan rangsang
coronia, anemia sistem saraf simpatis

Kontriksi vaskular,
STRES ( fisik atau
peningkatan frekuensi
psikis)
nadi, tekanan darah dan
kontraktilitas
Merusak sel-sel jantung,
meningkatkan kadar
leukosit
( proses inflamasi
jaringan) dan platelet.
Iskemia dan
hipoksia

Mengeluarkan
potasium, histamin Metabolisme sel berubah
dan serotinin dari aerobik menjadi
anaerobik

penumpukan asam
laktat

Energi ATP
menurun
Merangsang ujung-
ujung saraf
Na+>> dalam sel
K+>> di laur sel
nyeri

Kontrakso miokard
Saraf sensoris jantung merangsang terganggu
saraf sensoris pada bagian badan lain
(pada bidang medio spinalis-torakal).
Nyeri menjalar dan merangsang
sistem saraf otonom

anggina
Meningkatkan
pelepasan
norephineprine/
katekolamin

Aggregasi platelet dan

thromboxane A
meningkat