Angina Pectoris: Symptoms, Causes, Diagnosis, Evaluation

Angina pectoris occurs when myocardial demands exceed, myocardial oxygen supply decreased usually caused by obstruction of the coronary artery.chest pain due to an inadequate supply of oxygen to the heart muscle is characterized by a feeling of suffocation.

Etiology  | Risk factor  | Clinical Manifestation | Pattern of Angina | Diagnostic Evaluation | Management | Nursing management |

 

Angina Pectoris – Chest Pain – Risk factor, Clinical Manifestation

Introduction:-

  • Angina pectoris occurs when myocardial demands exceed, myocardial oxygen supply decreased usually caused by obstruction of the coronary artery.
  • chest pain due to an inadequate supply of oxygen to the heart muscle is characterized by a feeling of suffocation.

Etiology of Angina Pectoris:-

  • atherosclerosis
  • prolong narrowing

The Risk factor of Angina Pectoris:-

  • Thromboangiitis obliterans (inflammation of a small and medium vein and thrombosis of extremities.
  • Polycythemia Vera (thickness of blood)
  • Polyarteritis nodosa (inflammation of artery due to infiltration of eosinophils.)

{Note: Angina can be triggered by exercise, cold, or anything that increases the workload of heart}

Clinical manifestation of Angina Pectoris:-

  • Pain:-  location: 90% of the clients experience pain slightly left to the sternum.

duration:- Angina usually lasts for 10 min. however, attacks precipitate by emotional disturbance last for 15-20 min.

Severity: the pain is described as mild or moderate or often called as Discomfort.

  • Dyspnea, weakness, light headache, nausea, vomiting, emptiness, restlessness.

The pattern of Angina Pectoris:-

  1. Stable Angina:-It is an acute chest pain triggered by exercise or emotion.
  2. Unstable Angina:- It is also acute pain but unpredictable degree or cause.
  3. Variant Angina:- It is also called Prinzmetal’s angina and it is for a longer duration.
  4. Nocturnal angina:- It is possibly associated with rapid eye movement during sleeping or dreaming.
  5. Angina Decubitus:It is proximal chest pain that occurs when the client stands up.
  6. Post-Infarction Angina:-pain occurs after a heart attack.

Diagnostic Evaluation of Angina Pectoris:-

  • ECG
  • Coronary Angiography
  • Blood test
  • Echocardiogram
  • Electron beam computed domography [EBCD]

Management of Angina Pectoris:-

  • The objective of the medical management in angina is to decrease the oxygen demand of the myocardial and to increase the oxygen supply.
  • Medically these objectives are met through pharmacological therapy and control of risk factors. Medical management focus on these three points:-
  1. Relieve acute pain.
  2. Risk of coronary blood flow.
  3. Prevent further attack to reduce the risk of myocardial infarction.

A: Aspirin and antianginal therapy

B: beta-blocker and blood pressure control

C: cigarette smoking and cholesterol control

D: Dietary modification

E: Education and exercise.

  • Restore blood supply
  • PTCA
  • Intracoronary strain
  • Laser ablation
  • CABG (coronary artery bypass grafting)

Nursing management of Angina Pectoris:-

Nursing Diagnosis:-

  • Acute chest pain related to decreasing blood supply to the heart resulting from coronary artery obstruction,
  • Ineffective tissue perfusion related to decreased cardiac output as evidence by cyanosis, decrease arterial oxygen, and dyspnea.
  • Risk of heart failure related to the disease process.
  • Anxiety and fear are related to hospital admission, fear of death, fear of treatment procedure, and disease process.
  • Risk of impaired skin integrity related to bed rest, edema, and decrease tissue perfusion.

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