This document discusses angina pectoris, a clinical syndrome characterized by chest pain or pressure due to reduced blood flow to the heart. There are three main types of angina - stable, unstable, and variant. Risk factors include physical exertion, cold exposure, heavy meals, stress, and smoking. Diagnosis involves assessing symptoms, electrocardiograms, cardiac biomarkers, and imaging tests. Treatment focuses on relieving pain with nitroglycerin and preventing complications with beta blockers, calcium channel blockers, antiplatelets, and anticoagulants. Nursing priorities are to relieve pain, prevent myocardial complications, educate the patient, and support lifestyle changes.

1. ANGINA PECTORIS
Rozelle Mae Birador

3. ANGINA PECTORIS
It is a clinical syndrome usually characterized by
episodes or paroxysm of pain or pressure in the
anterior chest.

4. Risk factors for angina include:
Physical Exertion
Exposure to cold
Eating heavy meal
Stress or any emotion-
provoking situation

6. Atherosclerotic Disease

7. TYPES
Stable
• Most common type, precipitated by physical exertion, emotional stress, exposure to hot or cold
temperatures, heavy meals, and smoking
• Occurs in a regular pattern, usually lasts 5 minutes or less, and is easily relieved by medications
Unstable
• May be new onset of pain with exertion or at rest, or recent acceleration in severity of pain
• Occurs in no regular pattern, usually lasts longer (30 min- utes), not generally relieved with rest or
medications
• Sometimes grouped with myocardial infarction (MI) under the diagnosis of acute coronary syndrome
(ACS)
Variant
(Prinzmetal’s)
• Rare, usually occurs at rest—midnight to early morning hours
• Pain possibly severe
• Electrocardiogram (ECG) changes due to coronary artery spasm

8. CLINICAL MANIFESTATION
Pain
Mild indigestion to a choking
Heavy sensation in the upper chest
Weakness
Numbness in the arms, wrist, and hands
Shortness of Breath
Pallor
Diaphoresis
Dizziness or Lightheadedness
Nausea
Vomiting
Subsides with rest or nitroglycerin

9. ASSESSMENT AND DIAGNOSTIC
• HX- Clinical manifestation of ischemia
• 12-Lead Electrocardiogram (ECG)
• Cardiac Biomarker
• Nuclear Scan (cardiac catheterization,
coronary angiography)

10. PHARMACOLOGIC THERAPY
NITRATES- Nitroglycerin
BETA- BLOCKERS- Metropolol, Atenolol
CALCIUM CHANNEL BLOCKERS- Amlodipine,
Diltiazem
Antiplatelet- Aspirin, Clopidogrel, Prasugrel,
Glycoprotein: Abciximab, Eptifibatide
Anticoagulants- Heparin, Low molecular-
weight heparins: Enoxaparin, Dalterparin

11. NURSING DIAGNOSES
Risk for decrease cardiac tissue perfusion
Anxiety related to cardiac symptoms and possible death
Deficient knowledge about the underlying disease and
methods for avoiding complications
Noncompliance, ineffective management of therapeutic
regimen related to failure to accept necessary lifestyle
changes

12. Collaborative Problems/Potential Complications
• Potential complications of angina
include :
ACS and/or MI, dysrhythmias and
cardiac arrest, heart failure,
and cardiogenic shock.

13. Nursing Priorities
Relieve/control pain.
Prevent/minimize development of myocardial
complications.
Provide information about disease
process/prognosis and treatment.
Support patient/SO in initiating necessary
lifestyle/behavioral changes.

14. NURSING INTERVENTIONS
• Encourage to stop all activities and sit or rest
in bed in a semi-fowler’s position
• Measuring Vital Signs
• Observe for signs of respiratory distress
• Administer Nitroglycerin as prescribed
• Administer Oxygen therapy if the patient’s
respiratory rate is increased or oxygen
saturation is decreased