Caring For An Angina Patient Essays

Caring for An Angina Patient Essays
Nurses play a very important role in managing a patient from the moment of his admission up to
making a discharge plan. Each part of the nursing process is vital to the wellbeing of the person he is
taking care of. Clinical reasoning is always essential in each part of the nursing process from
assessment, setting up goals and intervention. Effective nursing management is done when a nurse
looks for the early and right cues at the right patient and implementing it at the right time. This essay
will delve deeper into the case of Rob Geis, a patient who was suffering from angina, given his
history and the signs and symptoms he experienced up to the time when his condition worsened to
Myocardial Infarction. This essay will also look into ... Show more content on Helpwriting.net ...
Geis. Subjective data would include asking him what he was doing when the chest pain started, the
quality of the pain, what parts of the body it is radiating, how severe it is and the time when the pain
occurred and how long (Lewis et al., 2012). Second, ask for the past medical history noting his
allergies, and previous illness and if there are any medications that he is currently taking. Third, ask
about his family history taking into consideration their religious beliefs. Fourth, ask about his diet,
lifestyle, exercise and his social history to map out a nursing plan from admission until his
discharge. Meanwhile, objective data includes check baseline observations which include blood
pressure, heart rate and peripheral pulses, respirations, neurological status, oxygen saturation rate.
Secondly, take baseline ECG to check the heart's electrical activity to note if there is an
improvement or deterioration (WebMD, 2012). Thirdly, chest x–ray should be done to visualize the
heart and lungs if there is any abnormality. Moreover, take his weight and do the physical
examination from head to toe should also be included. The information from his General
Practitioner will also give pertinent information about the history of his illness. On the other hand,
other helpful tools for assessing Mr. Geis are diagnostic tests which include a Troponin test to
determine if chest pain is due to
... Get more on HelpWriting.net ...

Pathological Consideration Of Acute Chest Pain Essay
PATHOLOGICAL CONSIDERATION OF ACUTE CHEST PAIN
Chest pain is among the most every now and again assessed introducing complaints in the
emergency department (ED). Diagnostic etiologies range from benign to life–debilitating. Inability
to diagnose the life–debilitating chest emergencies can prompt to catastrophic medical and legal
results for the patient and physician separately (Boie, 2005).
The first approach to assessing chest pain incorporates excluding life threatening reasons, which for
the most part incorporate (1)coronary artery disease (Kettunen and Talvensaari ,2009) (2)acute
aortic syndrome (AAS) (3)pulmonary embolism (PE) (4)esophageal rupture (5)tension
pneumothorax and (6)pericardial tamponade (Butler and Swencki, 2006). I–Pathology of Pulmonary
embolism (PE):
As the third most common reason of cardiovascular death after myocardial ischemia and stroke,
pulmonary embolism (PE) is a conceivably fatal condition connected with significant morbidity and
mortality (Araoz et al., 2007).
PE and DVT are two clinical presentations of venous thrombo–embolism and offer the same
predisposing factors. In many cases PE is a result of DVT (Pitts et al., 2008).
Thrombi generally form in the deep veins of the calf and after that propagate into the proximal
veins, including and above the popliteal veins, from which they will properly embolize. Around
79% of patients who present with pulmonary embolism have

Outline The Structure Of The Cardiovascular System
1. Outline the structures of the cardiovascular system
The transporting of blood through the whole body is done by the cardiovascular system. This one
continuum of blood vessels and arteries and is used to transport blood away from the heart and veins
transport the blood back toward the heart. Capillaries are used to transport blood to tissues cells and
the exchanging site for nutrients, gases and wastes. The heart is also a part of the cardio vascular
system Approximately the size of a person's fist the heart is a Hollow cone shaped, Weighs
approximately 300g, 2/3 left of the median plane And is located in the bony thorax between the
lungs. The pointed apex of the heart is pointed toward the left hip and rests on the diaphragm. The
heart consists of the myocardium which is the middle muscle layer of the heart. The endocardium
which is the inner most layer of the heart and The Pericardium is a double layer of serous membrane
with serous fluid in between. It protects the heart and anchors it to surrounding structures the
pericardium which a visceral inner and partial outer layer of the heart.
2. Give a brief overview of the normal function of the cardiovascular system
The cardiovascular system also consists of the heart which its main function is to pump blood. The
heart which is dived into for chambers two atrium and two ventricles. The right atrium is supplied
with blood for the inferior and superior vena cava and the blood is then filtered through the

Angina Essay
In Focus on Pharmacology Essentials For Health Professionals, Jahangir Moini states "angina
pectoris is a common form of ischemic heart disease and often precedes and accompanies MI"
(Moini, 2013. p.359). When having angina, a patient will feel pressure in the chest like a squeezing
sensation and the pain can travel to the jaw, down the arm, into the neck, shoulders, or back.
There are three types of angina: stable, unstable, and variant. Most common types are stable and
unstable. Stable angina is a result of plaque buildup which has caused narrowing of the coronary
artery. The body can get enough blood to the heart when it's in a resting state and not exerting itself.
When the need for exertion arises, climbing a set of stairs for example, it needs more oxygen since
the heart is working harder but the narrowed artery is preventing the increase in blood flow needed.
The angina symptoms will start to subside after taking nitroglycerin and resting. ... Show more
content on Helpwriting.net ...
This can occur while the body is in a state of rest unlike with stable angina. Nitroglycerin and rest
will not alleviate the uncomfortable feeling and pain. This typically occurs when there is a partial or
full blockage of the coronary artery due to a blood clot.
Variant angina can occur in people who do not even have hart disease. It is rare, but is the result of
coronary artery spasms. The spasms cause the walls to constrict which lessens or stops the blood
flow to the heart.
On the website CV Pharmacology, Richard Klabunde, PhD tells us that the classes of drugs to treat
angina are as

A Brief Note On Atherosclerosis And Coronary Spasms
1. Ms. T sought medical attention mainly because of intolerable chest pain after climbing several
flights of stairs; however, Ms. T has a history of conditions such as atherosclerosis and coronary
spasms. Atherosclerosis is the buildup of fatty material known as plaque, along the walls of arteries
causing the arteries to narrow (Taber's pg 224). Therefore, angina pectoris can result with exertion.
Also, coronary spasms can potentially be caused by plaque buildup and can occur in people who
have high cholesterol such as Ms. T. Also, coronary spasms are known to cause angina pectoris in
people (Taber's pg 2171). Ms. T's history of these conditions explains why she experiences episodes
of angina.
4. The two predominant types of angina are ... Show more content on Helpwriting.net ...
Propranolol HcL drug to drug interactions: general anesthesia, IV phenytoin, and verapamil may
cause additive myocardial depression. Additive bradycardia may occur with digoxin. Additive
hypotension may occur with other antihypertensives, acute ingestion of alcohol, or nitrates. Levels
may be decreased with chronic alcohol use. Concurrent use with amphetamines, cocaine, ephedrine,
epinephrine, norepinephrine, phenylephrine, or pseudoephedrinemay result in unopposed alpha–
adrenergic stimulation (excessive hypertension, bradycardia). Concurrent thyroid administration
may decrease effectiveness. May alter the effectiveness of insulin or oral hypoglycemics(dose
adjustments may be necessary). May decrease effectiveness of beta–adrenergic bronchodilatorsand
theophylline. May decrease beneficial beta cardiovascular effects of dopamine or dobutamine. Use
cautiously within 14 days of MAO inhibitor therapy (may result in hypertension). Cimetidine may
increase blood levels and toxicity. Concurrent NSAIDs may decrease antihypertensive action.
Smoking increases metabolism and decreases effects; smoking cessation may increase effects. May
increase levels of lidocaine and bupivacaine.
Nifedipine drug to drug interactions: Drug–Drug: Rifampin, rifabutin, phenobarbital, phenytoin,
orcarbamazepine may significantly decrease levels and effects; concurrent use is contraindicated.
Ketoconazole, fluconazole, itraconazole,clarithromycin,

Essay on The Dangers of Angina Pectoris
The Dangers of Angina Pectoris
3 Introduction
4 The Human Heart
5 Symptoms of Coronary Heart Disease
5 Heart Attack
5 Sudden Death
5 Angina
6 Angina Pectoris
6 Signs and Symptoms
7 Different Forms of Angina
8 Causes of Angina
9 Atherosclerosis
9 Plaque
10 Lipoproteins
10 Lipoproteins and Atheroma
11 Risk Factors
11 Family History
11 Diabetes
11 Hypertension
11 Cholesterol
12 Smoking
12 Multiple Risk Factors
13 Diagnosis
14 Drug Treatment
14 Nitrates
14 Beta–blockers
15 Calcium antagonists
15 Other Medications
16 Surgery
16 Coronary Bypass Surgery
17 Angioplasty
18 Self–Help
INTRODUCTION

In today's society, people are gaining medical knowledge at quite a fast pace. Treatments, cures, and
vaccines ... Show more content on Helpwriting.net ...
(see Fig. 1 – The Structure of the Heart)
Like any other organs in our body, the heart needs a supply of blood and oxygen, and coronary
arteries supply them. There are two main coronary arteries, the left coronary artery, and the right
coronary artery. They branch off the main artery of the body, the aorta. The right coronary artery
circles the right side and goes to the back of the heart. The left coronary artery further divides into
the left circumflex and the left anterior descending artery. These two left arteries feed the front and
the left side of the heart. The division of the left coronary artery is the reason why doctors usually
refer to three main coronary arteries. (Fig. 2 – Coronary Arteries)SYMPTOMS OF CORONARY
HEART DISEASE
There are three main symptoms of coronary heart disease: Heart Attack,
Sudden Death, and Angina.
Heart Attack
Heart attack occurs when a blood clot suddenly and completely blocks a diseased coronary artery,
resulting in the death of the heart muscle cells supplied by that artery. Coronary and Coronary
Thrombosis2 are terms that can refer to a heart attack. Another term, Acute myocardial infarction2,
means death of heart muscle due to an inadequate blood supply.
Sudden Death
Sudden death occurs due to cardiac arrest. Cardiac arrest may be the first symptom of coronary
artery disease and may occur without any symptoms or warning signs. Other causes of sudden
deaths include

Percutaneous Transluminal Coronary Intervention
Mr. Harry Bright has undergone a procedure called percutaneous transluminal coronary intervention
(PTCI) via femoral approach for the treatment of his progressive unstable angina. Femoral artery is
the most common access site used for PCI because of its size and its direct passageway to the heart
(Young, 2014 p.431; Cosman, Arthur, Bryant–Lukosius, Strachan, 2015 p.180). In this procedure, a
cardiac catheter followed by a stent is inserted to the artery to dilate the occluded blood vessel and
improve blood flow (Young, 2014 p.430). The occlusive atherosclerotic plaque are usually
associated with Mr. Bright's diabetes, hypetension and smoking history. Contrary to the positive
effect of PTCI, bleeding and hematoma formation are the most typical ... Show more content on
Helpwriting.net ...
No further data was mentioned apart from minimal oozing. This led to the understanding that
because angioplasty is an invasive procedure it is vital to perform a thorough assessment on the
wound site to check for signs of bleeding and infection. As cited by Benbow (2016 para.1) in her
article, an accurate wound assessment would yield to the delivery of effective nursing management
and prevention of impending health issues. Moreover, she also mentioned in her paper that
comorbidities such as diabetes, smoking, and ageing would slow down the healing process (para.4).
These comorbidities are well presented in Mr. Bright's history. This study is further augmented by
an evaluation research headed by Greatrex–White and Moxley (2013 p.295–296) wherein they
enumerated a criteria necessary for wound assessment. In their research, the wound assessmet tool
comprises of the following: details and characteristics, wound measurement using, tissue type,
exudate, pain, signs of infection, and surrounding skin. Furthermore, since hematoma formation, a
benchmark of wound assessment tends to occur after patient is discharged, educating him and his
significant other how to measure his hematoma is significant. Cosman et. al. (2015 p.182–183)
proposed different methods of measuring hematoma. A general method described includes the
precise measurement of length and width of the wound

Heart Disease : A Massive Worldwide Killer
Heart disease is a massive worldwide killer. In Australia alone coronary heart disease affects more
than 3.2% of the nation (Craft, Gordon, & Tiziani, 2011, p. 621). Statistics show that 7.5% of
Australians aged between 55 and 64 will be affected by acute coronary syndrome at some stage in
their lives and an astounding 25% of those aged over 75 also suffer. Coronary heart disease is
accountable for on average 20% of deaths in Australia and New Zealand (Craft, Gordon, & Tiziani,
2011, p. 621). Acute coronary syndrome leads to approximately ninety thousands hospitalisations
yearly (AstraZeneca Australia, 2014).
Acute coronary syndrome is cause by atherosclerosis, this begins when the endothelium, which is
the cell wall, becomes damaged ... Show more content on Helpwriting.net ...
Any changes in cardiac output due to heart failure directly affect the kidney's functioning
(Nursingtime.net, 2014). Blood test reveal irregular amounts of urea or creatinine may be seen as a
direct sign that the kidneys are not receiving sufficient blood flow to be able to perform at preferable
levels (Nursing times.net, 2014, p.20). A direct indicator of cardiac damage is Troponin T or
Troponin I proteins showing up in blood test. Troponin is only released when there is cardiac muscle
damage. The greater the levels of proteins, the greater the amount of cardiac damage (Mahajan &
Jarolim, 2014).
The common underlying pathophysiology of acute coronary syndrome is associated by a rupture of
an atherosclerotic plaque in a coronary artery, resulting in the development of a thrombus.
(AstraZeneca Australia, 2014). When plaques erode or rupture, the resulting thrombus restricts the
flow of blood to the heart muscle. A prolonged lack of blood supply results in necrosis of heart
muscle tissue and infarcted tissue remains permanently dysfunctional ("Acute Coronary Syndromes
(ACS): Coronary Artery Disease: Merck Manual Professional," 2014). Mr Pham's electrocardiogram
shows that he has anterior ST elevation myocardial infarction (anterior STEMI) Anterior Infarcts,
which Mr Pham has suffered, tend to be larger, so it conveys a far worse diagnosis for the patient
(Lome, 2014). It has been proven that outcomes from anterior and inferior infarctions carried a

The Effects Of Stable Angina And Chronic Heart Failure Essay
Intro – Nel (205 words)
Ivabradine has captured the attention of scientists and has opened up new possibilities for the
treatment of stable angina and chronic heart failure. Ivabradine is being developed as an anti–angina
drug in patients with stable coronary artery disease and was found to reduce heart rate by selectively
inhibiting the pacemaker (If) current in the sinoatrial node (Jedlickova et al., 2015). Recent studies
have noted how the reduction of heart rate caused by ivabradine has broader implications on heart
health, and also how ivabradine can potentially improve cardiovascular disease (CVD) by
mechanisms other than heart rate reduction. Studies have also looked at using ivabradine in more
than just treating stable chronic angina, but also in other types of CVD and even chest pains. O
'Connor et al., (2016) examined the effects of ivabradine following myocardial infarction in mice
and Jedlickova et al., (2015) through studying ivabradine used as an angina treatment in humans,
looked at the effects of ivabradine on endothelial function. These studies have highlighted how
ivabradine may not only be beneficial as a treatment via heart rate reduction, but also through
pleiotropic mechanisms (Heusch and Kleinbongard, 2016). Ivabradine is an important area of
research because it can be useful in more than one context.
Body – Nel (105 words)
Ivabradine inhibits hyper–polarisation – activated cyclic nucleotide–gated channels and selectively
inhibits the pacemaker

Characteristics Of A Stable Angina
Stable Angina
What is stable angina?
Stable angina is another term for chest pain that occurs with activity and improves with rest or a
medication called nitroglycerine. This is an extremely common condition that typically affects older
individuals with high blood pressure, diabetes, and elevated cholesterol. People with angina are at
increased risk for cardiovascular conditions such as heart attack, peripheral vascular disease, and
stroke. As opposed to stable angina, unstable angina is an emergency that can lead to heart attack
very quickly.
Since stable angina is so important, it is critical that patients be educated about the causes and
treatment of this condition. By the end of this article you will know the answers to these ... Show
more content on Helpwriting.net ...
Other symptoms that may occur during angina attacks include:
Difficulty breathing
Low energy
Exercise intolerance
Profuse sweating
Nausea or vomiting
There are no specific signs on physical examination that can diagnose angina.
How is angina diagnosed?
Angina is suspected based on symptoms and the diagnosis is typically confirmed with a stress test.
There are various types of stress tests. Your doctor may have you exercise on a treadmill while
monitoring your symptoms, blood pressure, heart rate, and electrocardiogram (stress EKG). If you
have an abnormal EKG at baseline, they might not be able to interpret the EKG during exercise, so
they may perform other tests that provide similar information – a stress echocardiogram or nuclear
stress test.
During a stress echocardiogram, your doctor will look at an ultrasound of your heart before and after
exercise. Similarly, during a nuclear stress test, you doctor will evaluate your heart before and after
exercise using nuclear imaging. If your heart pumps abnormally with exercise, this can suggest that
it is not receiving enough blood during physical activity.
Sometimes, individuals might not be able to use a treadmill due to severe arthritis in the hips or
knees, or because they are paraplegic or unable to walk. During these circumstances, your doctor
can administer an intravenous medication (eg, adenosine, dobutamine) to mimic physical activity. In
other words, your doctor will

Angina Pectoris: The Heart Killer Essay
Introduction
In today's society, people are gaining medical knowledge at quite a fast pace. Treatments, cures, and
vaccines for various diseases and disorders are being developed constantly, and yet, coronary
disease remains the number one killer in the world.
The media today concentrates intently on drug and alcohol abuse, homicides, AIDS, and so on.
What a lot of people aren't realizing is that coronary disease actually accounts for about 80% of
sudden deaths. In fact, the number of deaths from heart disease approximately equals to the number
of deaths from cancer, chronic lung disease, pneumonia and influenza, and others combined.
One of the ... Show more content on Helpwriting.net ...
These two left arteries feed the front and left side of the heart. The division of the left coronary
artery is the reason why doctors usually refer to three main coronary arteries.
Symptoms of Coronary Heart Disease
There are three main symptoms of coronary disease: heart attack, sudden death, and angina.
Heart attack occurs when a blood clot suddenly and completely blocks a diseased coronary artery,
resulting in the death of the heart muscle cells supplied by that artery. Coronary and Coronary
Thrombosis 2 are terms that can refer to a heart attack. Another term, Acute Myocardial Infarction 2,
means death of heart muscle due to an inadequate blood supply.
Sudden death occurs due to cardiac arrest. Cardiac arrest may be the first symptom of coronary
artery disease and may occur without any symptoms or warning signs. Other causes of sudden death
include drowning, suffocation, electrocution, drug overdose, trauma (such as automobile accidents),
and stroke. Drowning, suffocation, and drug overdose usually cause respiratory arrest which in turn
cause cardiac arrest. Trauma may cause sudden death by severe injury to the heart and brain, or by
severe blood loss. Stroke causes damage to the brain which can cause respiratory arrest and/or
cardiac arrest.
People with coronary heart disease, whether or not they have had a heart attack, experience

Unstable Angina Case Study
Unstable angina is a result of reversible myocardial ischemia causing irreversible damage condition
in which oxygen and blood flow to the heart is reduced or blocked (Overbaugh, 2009). PJ's
symptoms came as a surprise and shows of chest pain that radiate to the jaw and the left arm and
pain is not relieved. He is diaphoretic and pale. This is an indicative of unstable angina (Overbaugh,
2009).
Take into consideration his age and educational status, PJ education for unstable angina should
include: eat a heart healthy diet that is high in fruits, vegetables, fish, whole grains and lean meats,
exercise but avoid strenuous activities, reach and stay at a healthy weight, quit smoking, manage
other problems such as hypertension, diabetes and high

Angina Pectoris And Coronary Disease
Abstract: Angina pectoris and the coronary artery disease that can follow, can easily be mistaken as
a less severe problem, but knowing the facts, can save your life. There are three different types of
angina pectoris and can happen to both active and sedentary individuals . There are many symptoms,
causes, ways to diagnosis and treat that doctors can utilize to prolong the life of patients. Angina
pectoris is the medical term for chest pains, and is associated with coronary heart disease. This
occurs due to a blockage or the over time narrowing of of arteries that transport blood to the heart.
With angina pectoris, the causes, diagnosis and treatment steps can mean the difference between life
or death for an individual. The term angina ... Show more content on Helpwriting.net ...
In diagnosing of angina pectoris, a visit to the doctor is commonly the first step, or if symptoms are
severe, a visit to the the emergency room should be the start. The onset of angina can be felt on the
lateral side of the chest or body, can radiate to the left arm, jaw, neck, and back, and may be
associated with breathlessness, a burning sensation in the mid section, and often nausea. There are
many tests that can provide data for evaluation. The most common, and the initial test is an
Electrocardiogram or EKG, a stress test, nuclear stress test, chest x–ray and a Cardiac computerized
tomography or CT. The EKG records the hearts electrical activity, and a stress test evaluates the
heart under a monitored exercise test and can help the doctor to determine how hard your heart is
working under varied conditions. By using a chest x–ray, or a CT test, the doctor is able to see the
blood flow through the chest and can examine the heart functions using a special dye. These
capabilities have improved the testing and diagnosing of Angina and early detection has

The Mechanisms For The Development Of Thrombosis On Plaques
Figure 1 – (The mechanisms for the development of thrombosis on plaques. Relationship between
the state of coronary artery vessel wall and clinical syndrome. (a) Stable angina pectoris. (b) and (c)
Acute coronary syndromes, 2009) Currently, Padraig has stable angina as his angina appears on
exertion. His angina may stay stable or he may progress to have unstable angina and possibly a heart
attack. The medications and advice the doctor has given him is aiming to halt the progression of his
angina to unstable angina or a heart attack. What are the risk factors for angina? There are many risk
factors for angina, these may be unmodifiable or modifiable risk factors, they include things such as:
Unmodifiable: Age – Over 45 for men, over 55 for women. Gender – Men have a higher incidence
than premenopausal women, however the risk is equal in menopausal women. Family history –
Often members of the same family will have angina, a positive family history is considered in
people who have a first degree relative who has developed coronary artery disease before the age of
50. Some genetic conditions – Such as familial hyperlipidaemia, and deletion polymorphism in the
ACE gene. Modifiable: Hyperlipidaemia – High serum cholesterol with a low HDL value is strongly
associated with atheroma formations. Smoking – It is estimated that approximately 20% of deaths
from coronary artery disease are related to smoking. Hypertension – This causes damage to the

Angina Pectoris Research Paper
Angina pectoris is a clinical syndrome when the heart does not get enough oxygen from blood and
can lead to ischemia.22 Angina is classified into three classes: stable, unstable, and
printzmetal/variant.4,16,20
Stable angina is caused by narrowed arteries due to atherosclerosis. It is the most common form of
angina. It occurs when there is exertion or effort. Episodes of pain tend to be alike and usually lasts
a short time. It can be relieved by rest or anti–anginal drugs.4,16,20
Episodes of pain which tend to be changing in the characters are one of the characteristics of
unstable angina. It often occurs at rest times, and more severe and lasts longer than stable
angina.4,16,20
Printzmetal/variant angina usually occurs when the body in the ... Show more content on
Helpwriting.net ...
Electrocardiogram (ECG) will detect and records the heart's electrical activity.16 Stress test and
stress echocardiogram also can be performed.16 Last but not least, Computed Tomography (CT)
scan can be performed as well.16 It will show h¬–ow much calcium is in the arteries; the level of
calcium.16
Albrecht (2013) stated that in the healthy heart, the oxygen is delivered by epicardial vessels and
intramyocardial arteries and arterioles, where little resistance to blood flow is found in the epicardial
vessels. In angina pectoris patients, based on the pathophysiology, it is simply can be said that there
is an imbalance between the myocardial oxygen supply and demand.19,20 Oxygen demand is higher
than oxygen supply in the heart.19,20
High oxygen demand can be happened due to heart rate, ventricular pressure and volume that lead to
wall tension, and contractility.19 Low oxygen supply can be happened due to coronary blood flow
such as diastole duration, aortic diastolic pressure, and coronary vascular resistance.19
The Canadian Cardiovascular Society comes up with a system that is generally accepted to grading
angina pectoris. The grading can be seen in table

Symptoms And Treatment Of A Stable Angina
Stable Angina Stable angina, also known as angina pectoris, is more commonly known as chest
pain. As simple as it sounds, there are many underlying causes and complications that follow along
with this condition. These chest pains are most often accompanied by strenuous activities or
prolonged emotional stress. Angina is closely related to coronary artery disease. Coronary artery
disease leaves the arteries narrowed and restricted, which limits the flow of blood tremendously.
Poor blood flow to the heart means poor oxygenation. The muscles in the heart are then oxygen
deprived, which is the pain that the patient feels. The pain most often occurs when the cardiac
muscles actually need more oxygen at a higher demand than usual, and when the workload on the
heart has been increased. There are many conditions that increase the need for more oxygen, such as
hyperthyroidism and hypertension. More often than none, rest and/or nitrates usually relieve the
pain. If the pain is continuous while resting, the diagnosis can be changed to unstable angina. There
are many risk factors that contribute to angina. All of which leave the arteries damaged and
narrowed. Usually these risk factors coincide with one another. The number one factor is smoking
tobacco products. Smoking tobacco products damages the interior walls of arteries, leaving them
susceptible to deposits of cholesterol to build up and inhibit the flow of blood. Two comorbidities
that can contribute to angina

Chest Pain Case Studies
Discussion Post
Week Ten
6551, N–6 As a provider, one will take care of many females with varying degrees of chest
discomfort. Therefore, one must be able to assess, diagnose, and treat this problem. For the purpose
of this discussion, I will evaluate a patient that presents with chest pain. I will evaluate a case,
consider the signs and symptoms presented by the woman, and develop differential diagnoses for the
issue. I will also evaluate treatment options and education strategies for the patient.
Case Study The case study that I chose is that of a 63–year–old African American (AA) woman that
presents with intermittent chest pain for two weeks. She states that the pain varies in intensity and
resolves with rest. She does not feel that the pain has increased over time. She had an exercise stress
test one ... Show more content on Helpwriting.net ...
The pain related to the above issues can be sharp, aching, non–oppressive, pressure, and varies in
intensity. Many times CWS pain can be reproduced upon palpation. A lot of providers use CWS in
primary practice an exclusion diagnosis. However, this issue occurs frequently in the primary care
setting (Ronga, Vaucher, Haasenritter, Donner–Banzhoff, Bosner, Verdon, Bischoff, Burnand,
Favrat, & Herzig, 2012). Costochondritis is most likely the primary diagnosis for this patient.
Costochondritis is an inflammatory process that does not usually have a definite cause. However,
mild trauma to the chest wall, overuse of the arms, and a viral respiratory infections are common
causes for costochondritis (WebMD, 2017). The fact that this woman's pain in intermittent varies in
intensity, and is reproducible with palpation are indicators that costochondritis is the culprit causing
her

Symptoms And Treatment Of Coronary Artery Disease
D.L., a 33 year old female with history of Coronary Artery Disease was admitted with complaints of
chest pain. The patient had Percutaneous Transluminal Coronary Angioplasty or PCTA in 2011. The
chest pain started 3 days ago upon admission and described the pain as 3 out of 10 in pain scale for
severity. The patient stated that the pain feels like a squeezing pain on the chest and no aggravating
factors caused it as she recalls. The patient used Nitroglycerine to alleviate the pain, which lasted
about 4 hours each past several days. The patient also stated that she was not sick, no fever or chills,
and did not experience any nausea and vomiting.
The patient has a prescription of Plavix, Nitroglycerine, Aspirin, and Albuterol. She ... Show more
content on Helpwriting.net ...
Nitroglycerine was administered to aid in getting oxygenated blood to heart muscles. Aspirin was
given for antiplatelet effect (Deglin, Sanoski, Vallerand, 2013).
The patient brought herself to the hospital because of the necessity to seek medical help. The chest
pain was not relieved after 3 days when she decided to drive herself. The statement the patient
provided showed lack of knowledge and awareness of the possible danger she is facing by driving
herself to the hospital, particularly in the possibility of angina exacerbations while driving. The
husband was present during the interview. The husband stated that he did not realized the pain was
that bad. Both patient and family member lack awareness of the situation, they needed education
regarding the recognition of early signs and symptoms of angina. The husband mentioned having
fast foods most days of the week because of convenience and cost. They find Social and financial
awareness should be emphasized especially with their diet. A collaborative effort of a nutritionist
and cardiologist was suggested. The patient is a social drinker and a 10 pack/years smoker. The
client stated that smoking particularly is her stress–reliever. The client displays addiction with
substances. An emphasis from the social worker, cardiologist, and respiratory therapist that tobacco
are big contributors on worsening her

Health Information : Assessment Task Essay
Diploma of Nursing: HLT51612
Analyse Health Information: HLTAP501C
Assessment Task 1: Case Study
Case Study One
Mr. Bellows is an overweight, 51–year–old with a long history of angina. He is known to your
hospital and arrives in an ambulance with more severe symptoms than previous admissions. Mr.
Farmer informs the ambulance crew, the Anginine tablets he has taken, have not provided any
symptom relief.
He presents at Emergency Department (ED) with crushing central chest pain, which radiates down
his left arm. On arrival to ED, Mr. Farmer receives 300mg aspirin, followed by IV morphine
sulphate. A 12 lead ECG and blood tests reveal he has suffered an AMI.
Mr. Farmer on Day 5, is discharged home and recommended to take daily exercise and improve his
diet. Mr. Farmer had previously consumed regular take–away food, smoker of 35years and led a
sedentary lifestyle. Discharge medications prescribed include aspirin, metoprolol, an ACE inhibitor
(perindopril) and a statin (simvastatin)
Question 1
Clearly differentiate the pathophysiology of angina and myocardial infarction, including signs and
symptoms. (5 marks)
Angina Pectoris
Angina Pectoris is a disorder described by episodes of pain when the supply of oxygen to the heart
is inadequate to meet the needs of the heart (Bruyninckx 2011). Hypoxia can be the result of three
types of cardiac stressors:
Ischemia caused by coronary blood vessel obstruction as a result of vasospasm, thrombosis or
atherosclerosis. Ischemia can also

The Continuing Dilemma Of Angina Pectoris
The continuing dilemma of angina pectoris.
Look beyond the obvious!
"There is a disorder of the breast marked with strong and peculiar symptoms, considerable for the
kind of danger belonging to it, and not extremely rare, which deserves to be mentioned more at
length and of which I do not recollect any mention among medical authors. The seat of it, and sense
of strangling, and anxiety with which it is attended, may make it not improperly be called Angina
pectoris" (1)
Since the end of the eighteen century, when William Heberden published and presented in the Royal
College of Physicians in London his brilliant paper titled "Some Account of the Disorder of the
Breast" (1) and the subsequent theory of "the important of the coronary ... Show more content on
Helpwriting.net ...
Moreover, they are one of the main sources of health care spending and one of the principal
determinants of disability. According to recent data from the United States, direct and indirect costs
associated with cardiovascular disease are estimated at over $312 billion per year. Despite the fact
that real prevalence of stable angina pectoris is unknown and differs widely among different major
population studies, at present, angina prevalence remains high and is the most common initial
symptomatic presentation of cardiovascular disease. (5–6)
In past decades, clearly the interest in deeper understanding of this entity has increased and
considerable number of studies have emerged suggesting that angina might be consequence of
different clinical conditions that include, mainly, obstructive atherosclerosis of epicardial coronary
arteries but also a heterogeneous group of disorders related with abnormalities in the function and
structure of the coronary microcirculation.
Are we doing enough?
It is relatively common in our daily practice to deal with patients complaining of chest pain in the
absence of obstructive coronary artery diseases and without other clinical condition that might either
limited myocardial oxygen delivery or increased myocardial metabolic demand such as severe aortic
stenosis, anaemia or hypertrophic cardiomyopathy. It has been reported that up to one–half of
patients presenting with signs and

Compare And Contrast The Pathophysiology Of Angina
Question 1
Clearly differentiate the pathophysiology of angina and myocardial infarction, including signs and
symptoms. (5 marks)
Angina Pectoris
Angina Pectoris is a condition described by episodic pain when the oxygen supply to the heart is
inadequate to meet the heart's needs. Hypoxia can be the result of three types of cardiac stressors:
Ischemia resulting from coronary blood vessel obstruction caused by atherosclerosis, vasospasm,
thrombosis or embolism. Ischemia can also occur from reduced time for the coronary arteries to fill
with blood, as in tachyarrhythmia, or from reduced filling pressure in the coronary arteries, as in
severe hypotension or aortic valve disease (Bruyninckx 2011).
Hypoxemia, as in respiratory failure or severe ... Show more content on Helpwriting.net ...
Some people can be surprised that they had a heart attack because of the few side effects. The
common side effects of a MI include: (Bruyninckx 2011)
– Having chest pain and discomfort: the heart attack involves discomfort either in the centre or left
side of the chest lasting for a few minutes and stopping and returning. The pain can be described as
heartburn, pressure or squeezing.
– Shortness of breath: can occur when resting or with some physical activity.
– Upper body pain/discomfort: can occur in one /both arms, shoulders, back, neck, jaw
– Other common signs and symptoms include: feeling unusually tired for no reason, nausea,
vomiting, sweating, dyspnoea and dizziness.
Symptoms of a myocardial infarction can be very similar to those of angina.
In summary, myocardial infarction is where there is a complete blockage of blood supply to the
heart. In contrast, angina is chest pain or discomfort that usually occurs with activity or stress
resulting from poor blood flow through the blood vessels in the

Assessment Of Patients With Suspected Stable Angina
1.3.10 Assessment of patients with suspected stable angina Chest pain is a very common symptom,
and around 20% to 40% of the general population will experience chest pain in their lives(149). In
the UK, up to 2 % of visits to a general practitioner are due to new onset chest pain (150).
Approximately 5% of visits to the emergency department are due to a complaint of chest pain, and
up to 40% of emergency hospital admissions are the result of chest pain(149, 151). Approximately
52,000 new cases of angina per year are diagnosed in men and 43,000 in women. The incidence of
angina increases with age(123). A recent systematic review of observational data (6 studies) found
that the total mortality rate in angina patients was 2.8% to 6.6% per annum(121). At present it is
thought that stable angina does not cause permanent myocardial damage. However prompt diagnosis
and treatment is important to prevent further complications. Initiation of pharmacological
intervention has been shown to retard plaque disease progression and to stabilise the surface
endothelium(131). Traditionally men are considered to be at high risk. However Hemingway et al
reported that women have a similarly high incidence of angina when compared with men.
Additionally women with stable angina have an increased long–term coronary mortality when
compared with women from the general population (122, 124). Angina is associated with clinical
events that can affect prognosis, for example Von Arnim et al

A Short Note On The Game Changer And Acute Coronary...
aVR: A Game Changer in Acute Coronary Syndrome Case Presentation A 44–year–old Caucasian
male presented to the Emergency Department (ED) with intermittent episodes of moderate mid–
chest pain accompanied with tingling of arms, diaphoresis and shortness of breath that occurred on
and off for two weeks. He denied nausea, palpitations, or syncope. The patient was seen at another
ED twice for similar symptoms but was sent home for out–patient evaluation. He did not follow up
with his primary care provider. His past medical history was remarkable for controlled hypertension,
non–insulin dependent diabetes, depression and gastroesophageal reflux disease. Prescribed
medications included hydrochlorothiazide, metformin, citalopram, and ranitidine. His surgical
history was unremarkable and his family history included hypertension and hyperlipidemia but no
history of heart disease or sudden cardiac death. He had a 20 pack–year smoking history, occasional
alcohol, and no illicit drug use. Physical Assessment Vital signs were as follows: blood pressure
118/80 mm Hg; pulse 84 beats/minute; respirations 16/minute; oxygen saturation 99% on room air,
temperature 97.1 F, body mass index 27.45 kg/m2; pain 3/10. The patient was in no acute distress.
Lungs were clear to auscultation bilaterally with no use of accessory muscles. Cardiac exam
revealed normal rate and rhythm, no murmur, gallops, rub or jugular venous distention. His
abdomen was non–distended, non–tender, without masses,

Case Study Of Angina Pectoris
INTRODUCTION:
The word angina is well derived from origin of Latin word "Angere" which means "to choke" and
"pectus" means "chest" or it is also derived from origin of Greek word "Ankhone" which means a
"strangling". (Marc D Haber, Feb 18, 2015)
Angina is mostly caused by myocardial ischemia. Coronary atherosclerosis mostly causes reduction
in the oxygen delivery. During exercise or hard working heart need more oxygen rich blood. If
coronary arteries are unable to supply oxygen rich blood to heart because of its narrowing, than
there will arise chest pain known as angina. (shenozaki et al 2008)
Angina pectoris is, deadly strangling painful feeling generally present in the retro–sternal region.
The pain spread out to the neck, jaws, shoulders ... Show more content on Helpwriting.net ...
In epicardial vessels there is not enough resistance to blood flow in healthy heart. Due to the
presence of atherosclerotic plaques in the arteries or vessels, blood flow is slow down, but
autoregulation process can pay off to a certain degree. Autorgulation is the process of myocardial
vessel dilation in response to diminish supply of oxygen. By autoregulation process, there are rapid
changes in blood flow to heart because of increase in demand. Adenosine which is potent
vasodilator, are the key mediators that are involved in myocardial perfusion. Other mediators are
nitric oxide (NO), prostaglandins (PGE2), carbon dioxide (CO2) and hydrogen ions. Obstruction as
result of atherosclerosis can be fixed to coronary blood flow, or dynamics as with coronary

Angina Exercise Survey
inches of his waist circumference. Studies show that intra–abdominal obesity (excess fat in the
abdominal cavity) is closely associated with abnormal blood glucose and lipid, which increase the
risk of developing diabetes type 2, dyslipidemia, and cardiovascular disease (Kwon, 2009;
myhealthywaist.org, n.d). It is important for patient to start increasing physical activity by creating
an exercise program to reduce his weight and decrease the size of his waist. This patient was not
very active prior to hospitalize for stent placement because of his angina chest pain. After this
hospitalization, the patient still worries that his angina episode might come back. The intervention
on the exercise program starts with assessing the patient's background knowledge on his condition
and the benefits of exercise. The printed material on CVA, stent placement, and benefit of exercise
will be provided to him. This way, he can review the information when he gets home. I would also
use simple terms when explaining the ... Show more content on Helpwriting.net ...
Since the patient lives in a neighborhood where the streets are unsafe for exercise, I would
recommend him to drive, walk, or bike to a park nearby and walk for 30 minutes. He may also
exercise at home for 30 minutes each day, five days a week. The exercise that he can do at home
such as climb stairs, pushups, sit–ups, or jogging. The American Heart Association (AHA) (2016)
recommended the exercise for overall cardiovascular health are the following options: 1) at least 30
minutes of moderate–intensity aerobic activity at least five days a week for a total of 150 minutes;
or 2) at least 25 minutes of vigorous aerobic activity at least three days per week for a total of 75
minutes; or a combination of moderate– and vigorous–intensity aerobic activity; and 3) moderate–
to high–intensity muscle–strengthening activity at least two days per week for additional health

Total Knee Replacement
Nifedipine (Adalat,Procardia,others) Prototype Drug / .Therapeutic Class: Drug for hypertension
and angina Pharmacologic Class: Calcium channel blocker. ACTIONS AND USESNifedipine is
CCB generally prescribed for HTN and variant or vasospastic angina. It is occasionally used to treat
Raynaud's phenomenon and hypertrophic cardiomyopathy. Nifedipine acts by selectively bloking
calcium channels in myocardial and vascular smooth muscle, including those in the coronary
arteries. This results in less oxygen utilization by the heart, an increase in cardiac output, and a fall
in blood pressure. It is available as extended–release tablets (XL). ADMINISTRATION ALERTS
Do not administer immediate–release formulations of nifedipine if an ... Show more content on
Helpwriting.net ...
Ensure proper use and functioning of any home equipment obtained. | Ensuring therapeutic
effects:Continue frequent assessments as described earlier for therapeutic effects.(Blood pressure
and pulse should be within normal limits or within parameters set by health care provider. If drug is
given for angina and /or dysrhythmias, significant improvement in reports of pain, palpitations, or
ECG demonstrates improvement) | Encourage the patient to adopt a healthy lifestyle of low–fat food
choices, increased exercise, decreased alcohol consumption, and smoking cessation. | Encourage
appropriate lifestyle changes. Provide for dietitian consultation as needed. (Healthy

Angina Case Study Essay
CASE STUDY #3 CARDIOVASCULAR
A 56 year old male arrives in the emergency room after complaints of severe pain to the upper
abdomen and jaw. For 7 years he has been seeing a doctor off and on for high blood pressure. He
has hyperlipidemia. He smokes ½ packs of cigarettes per day.
(1) Differentiate 3 different types of angina and identify the associated clinical symptoms.
A. Classic or Stable Angina Pectoris which is also called Chronic Coronary Syndrome is the most
common form of angina. In stable angina, because of the buildup of plaque (stenotic
atherosclerotic), the coronary vessels has become much narrowed. Arteries that have become
severely narrowed (stenosed) poor dilation, "reduce coronary blood flow to a critical level," only
allowing enough blood to reach the heart while resting or sitting, when demand for oxygen is
decreased. With exertion, ... Show more content on Helpwriting.net ...
Prinzmetal or Variant Angina is caused by a spasm in a coronary artery, that narrows the artery and
causes decreased or stop blood flow to the heart, the pain is described as being unpredictable
attacks. Vasospasm has been acknowledged as the plausible means leading to Variant Angina, while
the cause of vasospasm is unknown. Suggested means include atherosclerosis–induced
hypercontractility, abnormal calcium flux across vascular smooth muscle and abnormal secretion of
vasospastic chemicals by local mast cells. The Clinical Symptoms of Prinzmetal or Variant Angina
are fatigue, weakness, nausea, chest pain , and most individuals with Prinzmetal Angina have
substantial coronary atherosclerosis, the initiation of ischemic symptoms is not linked to physical or
emotional exertion, heart rate, or other obvious causes of greater myocardial oxygen demand.
Patients with Variant Angina react well to treatment with calcium channelblocking drugs, which
prevent vascular smooth muscle contraction (Copstead & Banasik, 2013, p. 385).
(2) Outline the pathophysiology of ischemia and the role it plays in myocardial

Case Study Unstable Angina
1) Classical Angina (also called Stable Angina)
Can be caused by indigestion, emotional stress, when one's heart is working very hard, and not
getting as much oxygen as the heart needs. After rest, the pain goes away. Stable Angina does not
last very long.
2) Unstable Angina
Chest pain that is new, happens when working or at rest. It could be chest pain that continues to
worsen. This kind needs emergency care, possible treatment of drugs. It might be a warning of a
heart attack. Something is preventing enough blood flow or enough oxygen to get to the heart.
Unstable Angina last longer, and many times the pain is intense.
3) Variant Angina (also called Vasospastic Angina)
This kind doesn't usually happen very often, but is caused by spasms

Symptoms And Treatment Of Angina
Angina is pain due to an increase in demand of oxygen during activity such as exercise. Angina can
produce pain similar to that of a heart attack such as sternal pain between breast bones that radiates
to left arm, left jaw pain and heaviness on a person's chest. The pain can be described as burning,
squeezing, tightness even aching (Parikh & Kadowitz, 2014). The symptoms of angina are a result
of myocardial ischemia. This is a condition of insufficient blood flow from the coronary arteries to
heart muscle (Heston, 2015).
There are four types of angina: intractable, stable, unstable and variant. The principal cause for
unstable angina is coronary artery disease that occurs as a result of plaque buildup along the walls of
arteries. Furthermore the plaque causes a narrowing of arteries and constriction of blood flow to the
heart (What is Angina, 2011). When the heart is not supplied with enough blood therefore not
enough oxygen the muscle spasms, or aches and results in chest pain being felt (Heston, 2015).
Furthermore as lactic acid builds up pain can also be detected however if pain persists further testing
should be performed as ischemia my progress to infarction (McCance & Huether, 2014).
PJ presents with symptoms of chronic angina treated primarily with measures to control
precipitating factors and management of high risk comorbidities. He has mild hypertension with diet
control and medications to manage his hypertension. He does not report further risk factors such as

Angina Pectoris Case Analysis
Angina pectoris is a term used to describe the syndrome of chest pain resulting from myocardial
ischemia (Griffin et al., 2008). Normal non–ischemic myocardial tissues differ from the cardiac
tissue of an individual with myocardial ischemia because the normal tissue has adequate blood
supply whereas the tissue in angina has inadequate blood supply from blocked coronary arteries.
Unstable angina is diagnosed when ischemia is neither severe nor prolongs for more than 20
minutes and regularly occurs at rest (Sami & Willerson, 2010). Patients who have unstable angina
are at a high risk for a new infarction and its sequelae such as cardiac death until the endothelial
injury is repaired. The purpose of this paper is to present a case analysis of ... Show more content on
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It can be caused by a reduction in coronary artery luminal diameter. According to Wilensky (2012),
the artery luminal narrowing can stem from progressive atherosclerotic intrusion into the lumen or
by sudden acute vasoconstriction or thrombus. In normal development, the individual does not
develop angina because the lumen of the coronary arteries are patent without occlusion from
atherosclerotic plaques, vasoconstriction or thrombus. The onset of symptoms is sudden when
thrombus formation is the direct cause of unstable angina. Following the onset of symptoms,
unstable angina progresses rapidly and ends in severe symptoms at rest. The rupture of a vulnerable
plague with thrombus formation influences the fast change from a stable to unstable lesion
(Wilensky, 2012).

Angina Pectoris Essay
Name and explain the three different types of angina pectoris –
Angina pectoris is a symptom of underlying heart condition. It is characterized with symptoms such
as severe pressing chest pain or heaviness radiating to the neck, jaw back and arm. The primary
cause of angina pectoris is the imbalance between myocardial oxygen demand and the oxygen
supplied by the coronary artery.
1. Stable angina – this occurs when the heart has to work harder than it normally needs too. Example
when excising, you might overexert yourself and feel chest pain or discomfort. Sometimes
overeating or eating too fast may cause this condition as well. Smoking is also a factor. Extremes in
emotion such as being too angry or upset may also provoke this condition.

A Brief Note On Coronary Artery Disease
Coronary Artery Disease is a condition where the blood flow through the coronary arteries of the
heart become partially or completely blocked by plaque buildup. CAD is responsible for over
500,000 deaths in the USA annually. Unfortunately in ¼ of the population, death is the first warning
sign of CAD. Atherosclerosis is the process by which plaque builds up in the vessels that supply
blood and oxygen to the heart muscle. This lack of blood flow is called ischemia, which will lead to
angina in many cases. Angina is caused by a lack of perfusion of the myocardium. CAD is a disease
that is developed over time due to unchanged risk factors such as obesity, sedentary lifestyle,
hyperlipidemia , cigarette smoking, and hyperlipidemia. The severity of Coronary Artery Disease
can be managed through lifestyle changes and medication. If the disease has advanced beyond
natural repair by lifestyle modifications, surgery may be the next option. Coronary Artery Bypass
Graft (CABG) surgery or placement of cardiac stents are the two most common forms of surgery to
fix CAD. These surgeries are not a substitute for lifestyle modifications, but may help those with
severe CAD begin to make lifestyle changes without symptoms arising at low intensity exercises.
With Coronary Artery Disease being the number one cause of death in the Unites States, there is a
lot of research on how to prevent, diagnose, and manage the disease. Prevention of CAD mainly
consists of healthy lifestyle choices, but

Study Essay example
Read the article Diagnosis Coding and Medical Necessity: Rules and Reimbursement by Janis
Cogley located on the AHIMA Body of Knowledge (BOK) at http://www.ahima.org. This article
discusses how Medicare Carriers and Fiscal Intermediaries use coverage determinations to establish
medical necessity. When the condition(s) of a patient are expected to not meet medical necessity
requirements for a test, procedure, or service, the provider has the obligation under the Beneficiary
Notices Initiative to alert the Medicare beneficiary prior to rendering the service. The Medicare
beneficiary is notified via the Advance Beneficiary Notice (ABN) (see page 235 in Appendix B).
The Medicare beneficiary may choose to complete the ABN and provide ... Show more content on
Helpwriting.net ...
Therefore, these codes should be used to identify stable angina and documentation should support
that diagnosis. Further, around $20,790.00 has been written off due to ABNs not being issued for
this cardiac rehabilitation service. Questions a. What went wrong in the revenue cycle? There was
no revenue. Like it is listed above after auditing the remittance advice logs and medical records, the
Revenue Cycle Team has determined that medical necessity is not being met for code 93798
(Physician services for outpatient cardiac rehabilitation; with continuous ECG monitoring [per
session]) and around $20,790.00 was written off due to ABN's (Advance Beneficiary Notice) not
being issued. b. How would you suggest rectifying this issue? "This article discusses how Medicare
Carriers and Fiscal Intermediaries use coverage determinations to establish medical necessity. When
the condition(s) of a patient are expected to not meet medical necessity requirements for a test,
procedure, or service, the provider has the obligation under the

Unstable Angina Case Study
Current Treatment and Consideration of Evidence Base: Upon admission, patient was most–likely
suspected of having ACS (acute coronary syndrome) because of CHD (coronary heart disease)
(NICE, 2014c). Troponin T High Sensitivity Test was carried out to distinguish whether chest pains
were because of NSTEMI or unstable angina (NICE, 2014b). This led to diagnosis of unstable
angina. His current treatment with regards to drug interactions is okay, except that enoxaparin has a
clinically significant interaction with aspirin (2015, p. 1199). This can be discounted for due to his
condition.
Patient has a CVD (cardiovascular disease); can be exacerbated by having high cholesterol (could be
the cause of his angina). Therefore, atorvastatin 80 mg was initiated for secondary prevention of CV
... Show more content on Helpwriting.net ...
Mention important benefits of quitting such as if patient quits smoking for 5 years or more, risk of
heart attack decreases by 50 to 70 percent (2012). Refer patient to NHS Stop smoking Service to
further help quitting. Emphasize important of exercise and diet on CVD progression. Explain how
active lifestyle reduces heart attack risk by 45% (2012). 2 hours and 30 minutes of moderate–
intensity aerobic activity every week is ideal, for example, walking fast or pushing a lawn mower
(NHS, 2014). Counsel patient on returning to normal day to day activities; ideal to wait 2 months
after CABG before doing strenuous activities (RCS, 2014). Emphasize importance of diet on CVD
progression. Mention important benefits such as that for every percent his serum cholesterol is
reduced, chance of having a heart attack is reduced by 2 percent. Patient should be counselled to
reduce salt intake to less than six grams a day, avoid caffeinated drinks, eat at least 5 portions of
fruits and vegetables a day, 2 portions of fish a week, and 4–5 portions of unsalted nuts, seed and
legumes per

Coronary Heart Disease ( Chd )
Introduction
Coronary heart disease (CHD), also known as ischemic heart disease is the most prevalent form of
cardiovascular disease in Australia (Australian Institute of Health and Welfare, 2014). While over
20,000 of deaths in 2011 were attributed to CHD. There were estimated 590,000 Australians 18
years old and above diagnosed with CHD in 2011–2012 (AIHW, 2014; Craft, 2014, pg. 596).
Myocardial ischaemia is a common form of CHD. A sufficient coronary artery blood flow is
essential to supply oxygen for normal cardiac activities. Myocardial ischaemia develops when there
is an insufficient supply of blood and oxygen to support the function of myocardial cells (Craft,
2014, pg. 599). A decrease in blood supply can led to the formation of atherosclerotic plaques by
narrowing or occluding the arteries. Other conditions such as hypotension, coronary spasm,
dysthymias, hypoxemia and anaemia can also decrease the blood and oxygen supply to the
myocardial cells (McCance & Huether, 2014, pg. 1153)
A common symptom for myocardial ischaemia is angina – chest pain. Angina can occur in two
forms: stable or variant angina (McCance & Huether, 2014, pg. 1154). Stable angina is caused by
myocardial ischaemia. The symptoms are usually described as sensation of heaviness, pressing or
squeezing pain, and sometimes may radiate to other places such as left shoulder, arm, lower jaw and
neck (McCance & Huether, 2014, pg. 1154; Touhy, Jett, Ebersole, & Hess, 2012, pg. 270). On the
other hand,

Angina Vs Mi
Explanation of the difference between angina and a MI
A myocardial infarction is a serious condition where there is complete blockage of blood supply to
the heart. It may cause heart attack. In other hand, angina is chest pain, tightness or discomfort that
usually occurs with activity or stress resulting from poor blood flow through the blood vessels in the
heart. It gets better with rest, medicine called nitro–glycerine, or both. Angina does not damage the
heart muscle, like an MI does. Angina may be a warning sign that we are at risk for an MI.
Three predisposing/risk factors for heart disease.
Eventually there are many risk factors for heart disease. But some risk factors for heart disease are
under our control and some are not. Coronary ... Show more content on Helpwriting.net ...
This process results in no blood flow to a part of the heart muscle leading to death of some heart
muscle downstream form the coronary artery occlusion. Normally there are two main coronary
arteries in people; their function is to deliver oxygenated blood to the heart muscle. When gradual
blockages develop in these vessels, the chance of heart attack increases.
Explanation of why a thrombolytic drug is administered in the given scenario. Thrombolytic therapy
is the use of drugs to break up or dissolve blood clots, which are the main cause of both heart attacks
and stroke. A blood clot can block the arteries to the heart. This can cause a heart attack, when part
of the heart muscle dies due to a lack of oxygen being delivered by the blood.
Thrombolytic work by dissolving a major clot quickly. This helps restart blood flow to the heart and
helps prevent damage to the heart muscle. Thrombolytic can stop a heart attack that would otherwise
be deadly.
The drug restores some blood flow to the heart in most patients. However, the blood flow may not
be completely normal and there may still be a small amount of muscle damaged. Additional therapy,
such as cardiac catheterization or angioplasty, may be

Unstable Angina Results Of A Myocardial Ischemia
Unstable angina results in a myocardial ischemia that is reversible. This may show signs of
atherosclerotic plaque rupture and an infraction may follow. Unstable angina will occur when
superficial erosion of plaque leads to vasoconstriction and thrombotic vessel occlusion (Mccance &
Huether 2014). This will occur for no more that ten to twenty minutes and perfusion returns before
myocardial necrosis. Unstable angina characteristics are angina that occurs when a patient is at rest,
it will limit the patient from activities and the patient has had a prior diagnosis of angina that last
longer and increase in frequency. Patients will also present with increased dyspnea, anxiety and
diaphoretic as angina worsen (Mccance & Huether ... Show more content on Helpwriting.net ...
Patient WS is a 52 years old male his complained of crushing chest pain, shortness of breathe with
exertion and diaphoretic. His has history of present illness of angina. The patient has a history of
hypertension, high cholesterol, and cholecystectomy. He is a full–time carpenter, no known
allergies, smokes one pack per day, and no active exercise. The patient takes one heavy meal per day
and mostly skips breakfast and eats fast foods for lunch. He has a health coverage plan from a union
but the plan does not cover his current ailments. He also exhibits non–verbal signs like stress and
has depressive indicators for instance excess sleeping and over eating. He is aware of his condition
and normally goes to a clinic associated with his union, though his cover does not cater for his
current medical prescriptions. The vital signs he shows including BPI indicate 160/92 left are
sitting; P: 60; R: 16; T: 98; weight: 220lbs.; height: 70". His physical assessment showed decreased
pedal pulses BL with lower leg edema from ankle to mid. No lymph nodes, decreased breathe
sounds throughout, no adventitious sounds in the lungs. The heart has RRR without murmur, and
carotids examination revealed right bruit. He has android obesity, WC = 44 inches. The lab test
results showed Total cholesterol – 210, LDL– 200, HDL– 25, Triglycerides – 250, Fasting blood
sugar – 140, HgbA1c – 7.5, CXR – hyperinflation

Stable Angina Pectoris
Stable Angina Among Women and MEN
Angina pectoris is a health care problem that is commonly misdiagnosed among women. This paper
will discuss the studies done in the article 'Stable Angina Among Women and Men' by Harry
Hemingway. This study goes into detail on the difference in occurrence and diagnoses of angina
pectoris between women and men. This paper will discuss the etiology, pathophysiology, the effects
of angina pectoris on a person life, and how this article will change the way practice.
Angina Pectoris
Etiology
Angina pectoris is a condition that is seen very often in the healthcare setting. According to
Hemingway, McCallum, Shipley, Manderbacka, and Martikainen, Keskimäki (2006) commonly, the
age of those affected by this condition ... Show more content on Helpwriting.net ...
Hemingway states that stable angina is poorly understood particularly in women (2006, p. 1404).
The most common cause of death in women is coronary disease, and among women, stable angina is
the most common initial symptomatic presentation (Hemingway, McCallum, Shipley et.all 2006).
Often times, women with stable angina are considered to have a soft diagnosis with less severe
prognostic implications than men. This article thoroughly discusses the lack of studies done to really
show the difference between gender in the incidence and prognostic effects of angina. The results of
the studies showed that the standardized annual incidence of nitrate controlled angina was higher in
women than in men. However, among all cases of angina, women were less likely to test positive
than men, but men were more likely to be tested than women. This could be the reason for the
higher incidence of positive test results for angina in men (Hemingway, McCallum, Shipley et.all
2006). Hemingway, McCallum, Shipley et.all (2006) states that "not all angina is diagnosed and
treated, particularly in women, this may relate to gender differences in symptoms or physician
perception of risk" (p. 1409). With all the evidence and tests gathered in this

Home Remedies for Angina Essay
Angina is a severe pain in the chest that is caused due to ischemia of the heart muscle. It happens
due to lack of blood which results in shortage of oxygen. Generally there may be obstruction or
spasm of the heart blood vessel called the coronary arteries that creates a feeling that the heart is
strangled. Angina may or may not cause a heart attack with or without pain. Nevertheless there can
be pain in other part of the body like shoulders, arms, jaw, neck and back.
Types of Angina
There are basically three types of angina which are listed below:
Stable angina
It is the discomfort of the chest associated with minimal or no existence symptoms at rest.
Unstable angina
This is an acute problem of coronary symptom that can change ... Show more content on
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Nausea
Breathing problems
Home Remedies for Angina using natural products
Natural products like Indian gooseberry, honey, lemon, garlic. Grapes, castor oil are all beneficial
for angina.
Home Remedies for Angina using Indian gooseberry and honey
Indian gooseberry also known as amla is one of the natural source for vitamin C. it can be taken in
any form like fresh juice or dried. You can add to food items and enhance the flavor. Amla is used in
medicinal preparation because of its medicinal values.
Honey is another good remedy. You can prepare a solution by adding a teaspoon of honey in warm
water and squeezing a half piece of lemon. This should be taken in empty stomach and during the
early hours of the day.
Home Remedies for Angina using garlic and parsley
Another popular ingredient is garlic that is extensively used in various food varieties. You can
always add garlic to fresh salads as it most effective way of retaining its medicinal properties.
Regular intake of garlic reduces the chances of getting many heart disorders.
Parsley is another alternate to treat angina. It can be taken in the form of fresh leaves and also in the
dried form. The dried parsley can be used in tea that gives a fresh aroma and taste.

Home Remedies for Angina using grapes, apple and lemon
One of the traditional remedy for heart ailments used grapes for curing angina.
Apple is also used in curing many heart

Caring For An Angina Patient Essays

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Caring For An Angina Patient Essays