Angina Pectoris: Symptoms, Causes, Diagnosis, Evaluation

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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