This document discusses angina pectoris, or angina, which is a type of chest pain caused by reduced blood flow to the heart. It defines angina as chest pain or discomfort that occurs when the heart muscle does not receive enough blood. The document outlines the main types of angina including stable angina, unstable angina, variant angina, and microvascular angina. It also discusses the causes, signs and symptoms, diagnostic evaluations, medical and surgical management, and nursing care for patients experiencing angina.

1. ANGINA PECTORIS
BY
MR. RAVISHANKAR
NURSING TUTOR
OJASWINI NURSING COLLEGE, SAGAR

2. INTRODUCTION:-
Angina is a symptom of coronary artery disease. Angina is also called
angina pectoris. Angina pain is often described as squeezing, pressure,
heaviness, tightness or pain in the chest. It may feel like a heavy weight
lying on the chest. A type of chest pain caused by reduced blood flow to
the heart.

3. DEFINITION:-
• Angina pectoris is chest pain or discomfort that occurs when the heart
muscle doesn't get enough blood.
• Angina pectoris is chest pain resulting from myocardial ischemia
(inadequate blood supply to myocardium).

4. TYPES:-
1. Stable angina-
 Stable angina is brought on when the heart is working harder then usual such as
during exercise.
 It has regular pattern and can be predict to happen over months or even year.
 Symptoms are relieved by rest or medication.

5. 2.UNSTABLE ANGINA
Unstable angina does not follow a regular pattern.
It can occurs when at rest .
This version can signal a future heart attack within a short time
–hours or week.

6. 3.VARIANT ANGINA:-
Its always occurs during periods or rest, usually at night.
The cause is a spasm of coronary artery.
People with heart valve disease or hypertension .

7. 4.MICROVASCULAR ANGINA
Patient have chest pain but do not seems to have a blockage in a
coronary artery.
Pain in the chest is because the tiny blood vessels that feed the heart,
arm are not working properly.

8. CAUSES:-
Age – men older than 45 & women older than 55
Atherosclerosis
Smoking, obesity, diabetes mellitus
High BP and blood cholesterol level
Excess intake fat & salt
Overwork
Stress
Exposure to cold

9. SIGN AND SYMPTOMS:-
Heaviness
Tightening
Burning or aching across the chest
Pain in neck, jaw, arms, shoulders, back.
Indigestion
Weakness
Sweating
Nausea
Shortness of breath

10. DIAGNOSTIC EVALUATION:-
ECG
Chest X-ray
Coronary angiography
Holter monitoring
Exercise treadmill test
CT coronary angiography
Blood test

11. MEDICAL MANAGEMENT:-
Calcium channel blockers- nifedipine, amlodipine
Anticoagulant- aspirin, heparin
Antihypertensive drug
Cholesterol lowering agent- statins

12. ANTI-PHARMACOLOGIC INTERVENTION-
Bed rest
Monitor for chest discomfort
Place the patient on cardiac monitor
Life style modification

13. SURGICAL MANAGEMENT:-
Coronary artery bypass surgery- it is a surgical procedure in which
one or more blocked coronary artery are bypassed by a blood vessels
graft to restore normal blood flow to the heart.

14. Percutaneous transluminal coronary angioplasty- a special catheter is
inserted into the coronary artery to be treated in the femoral
artery in the groin. First a guide wire is inserted and them a
catheter which inject a dye.

15. Coronary stent- A coronary stent is a tube-shaped device placed in the
coronary arteries that supply blood to the heart, to keep the arteries open
in the treatment of coronary heart disease.

16. Atherectomy- it is a catheter-based procedure used to remove
plaque buildup in the arteries. Your doctor may recommend an
atherectomy if the plaque is very hard or a blockage still exists after
angioplasty and stenting.

17. Transmyocardial laser revascularization- use of a laser
to creating channels in the lower left chamber of the heart
which may increase blood flow within the heart.

18. NURSING MANAGEMENT:-
Reducing pain
Promoting adequate tissue
perfusion-
Improving cardiac output- assess
heart rate
Improving respiratory function