ANGINA PECTORIS

                                                              ANGINA PECTORIS

What is Angina ?

Angina Pectoris is a disease marked by brief sudden attacks of chest pain or discomfort caused by deficient oxygenation of the heart muscles usually due to impaired blood flow to the heart.

Pathophysiology :

Atherosclerosis leads to narrowing of the coronary artery resulting in inadequate blood flow to heart muscles causing chest pain.

Etiology & risk factors :

• Age > 55 years for men & >65 years for women
• Smoking
• Hypertension
• Diabetes
• Renal dysfunction 
• Obesity

Types:

Stable Angina : Most common.

•  Pain occurs due to emotional stress , heavy exercise. 
• Usually resolved at rest or nitrate therapy.

Unstable Angina: Does not resolved by rest if occured due to semotional & physical stress. 

less effective in response to nitroglycerine.

Prinzmental Angina : also called as Vasospastic Angina

• Usually occurs at rest & is not triggered by stressors. 
• Mostly occurs at night.

Medical & Nursing Management :

• Note for PQRST.

P-Place of pain

Q- Quality of pain  { stabbing, squeezing etc}

R- Radiating pain elsewhere in the body

S- Severity of pain on painscore

T- Timing of lasting of pain

• Nitroglycerine- sublingual or patch
• Beta blockers - Propanolol, Atenolol, Nadolol
• Aspirin for antiplatlet effect
• Analgesic- Morphine IV to reduce chest pain
• 2-4 litres of oxygen
• Semi-Fowler's position of the patient
• Notify physician if HR<60 bpm & BP < 90/60 mm Hg

Distinctive Facts :

• Ix- ECG, Coronary Angiography, PET scan, Echocardiogram, PT/INR, Cholesterol pannel
• Surgery : PTCA< Coronary artery stenting, CABG
• Duke trademill score

 

Prognosis :

• Often managed by lifestyle modification
• Health education is very important to reduce complications & for good prognosis

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