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angina

Angina. Clinical syndrome characterize by episodes of chest discomfort (pain) or pressureTypically caused by an imbalance in myocardial oxygen supply versus myocardial oxygen demand.>6 million people in US have angina.. Etiology. Typically caused by atherosclerotic heart disease in combination with increased oxygen demand.Unstable angina is also thought to be associated with a temporary blood clot (plaque rupture and bleed) superimposed on atherosclerotic plaque..

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angina

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    1. Angina Leslie Mickles, RN, MSN, ABD

    2. Angina Clinical syndrome characterize by episodes of chest discomfort (pain) or pressure Typically caused by an imbalance in myocardial oxygen supply versus myocardial oxygen demand. >6 million people in US have angina.

    3. Etiology Typically caused by atherosclerotic heart disease in combination with increased oxygen demand. Unstable angina is also thought to be associated with a temporary blood clot (plaque rupture and bleed) superimposed on atherosclerotic plaque.

    4. Types of Angina Stable Unstable Variant (Prinzemetal) Silent Ischemia

    5. Stable angina is the most common type. It occurs when the heart is working harder than usual. There is a regular pattern to stable angina. After several episodes, you learn to recognize the pattern and can predict when it will occur. The pain usually goes away in a few minutes when you rest or take your angina medicine. Stable angina is not a heart attack but makes it more likely that you will have a heart attack in the future.

    6. Also called preinfarction angina or crescendo angina Unlike stable angina, it does not follow a pattern. It can occur without physical exertion and is not relieved by rest or medicine. Unstable Angina

    7. Variant Angina Also called Prinzmetal Angina Variant angina is rare. It usually occurs at rest. The pain can be severe and usually occurs between midnight and early morning. It is relieved by medication Thought to be caused by coronary vasospasms

    8. Preciptiating Conditions ASHD Hypertension Aortic Valve Disease Anemia Dysrhythmias Thyrotoxicosis Physical Exertion Heavy Meal Stress Coronary Artery Vasospasm Heart failure

    9. Manifestation The pain or discomfort of angina: Is often described as pressure, squeezing, burning, or tightness in the chest Usually starts in the chest behind the breastbone May also occur in the arms, shoulders, neck, jaw, throat, or back May feel like indigestion.

    10. Classifications of Angina

    11. Diagnosis Typical Chest Pain History Risk Factors Diagnositc Tests Stress Test positive Stress Echo Cardiac Enzymes negative Cardiac Catheterization with coronary angiography

    12. Treatment Support care during acute event Oxygen Rest Nitroglycerin Morphine sulfate Arrhythmia monitoring Monitoring vital signs Monitoring for complications (e.g. heart failure) R/O MI

    13. Treatment CABG PTCA (Aggrastat or Reopro) and stent Angioplasty or athrectomy Long term medical management Nitrates Beta blockers Calcium Channel blockers ACE inhibitors or ARBs Aspirin or other antiplatlet therapy (e.g. plavix, ticlid) Take nitrate before an event that usually causes chest pain Meds for hyperlipidemia Education on dietary and activity changes

    14. Vasodilators: Nitrates

    15. The Many Faces of Nitro

    16. ACE (angiotensin converting enzyme) Inhibitors

    17. ARBs (angiotensin II receptor blockers)

    18. Calcium Channel Blockers

    23. Education of Patient Life style modifications STOP SMOKING!!!!!!!! Nitroglycerin use Recognizing symptoms If pain persists after 15 minutes or 3 nitro call 911.

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