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1. Inamullah Khan
2012/KMU/RCN/59
4th year
Class NO 52
inamullah Khan 1

2. Angina
Angina pectoris -(Latin: squeezing
of the chest) is chest pain, discomfort,
or tightness that occurs when an area
of the heart muscle is receiving
decreased blood oxygen supply.
inamullah Khan 2

3. Types of Angina
Pain or discomfort in the chest that
typically lasts from 1 to 15 minutes. The
condition is classified by the pattern of
attacks into
Stable,
and
Unstable angina.
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4. Stable angina
 Stable (or chronic) angina is brought on
when the heart is working harder than usual,
such as during exercise. It has a regular pattern
and can be happen over months or even years.
Symptoms are relieved by rest or medication.
inamullah Khan 4

5. Unstable angina
 Unstable angina does not follow a regular
pattern. It can occur when at rest and is
considered more serious as it is not relieved by
rest or medicine. This version can signal a
future heart attack within a short time - hours
or weeks.
inamullah Khan 5

6. Angina risk factors
Risk factors include:
 Unhealthy cholesterol levels
 Hypertension Tobacco smoking
 Diabetes
 Being overweight or obese
 Sedentary lifestyle
 Being over 45 for men and over 55 for women
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7. Causes of angina
Angina is most frequently the result of
underlying coronary artery disease.
Physical exertion is a common trigger for
stable angina.
Unstable angina is often caused by blood
clots that partially or totally block an
artery.
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8. Symptoms of angina
 Angina is usually felt as a squeezing, pressure, heaviness,
tightening, squeezing, burning or aching across the chest,
usually starting behind the breastbone. This pain often
spreads to the neck, jaw, arms, shoulders, throat, back, or
even the teeth.
 Stable angina usually is unsurprising, lasts a short period
of time, and may feel like gas or indigestion. Unstable
angina occurs at rest, is surprising, last longer, and may
worsen over time.
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9. Exams and Tests
Coronary angiography
Blood cholesterol profile
ECG
Nuclear medicine (thallium) stress
test
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10. Nursing Assessment
Gather information about the patient’s
symptoms and activities, especially those
that precede and precipitate attacks of
angina pectoris.
The patient’s response to angina
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11. Nursing Diagnosis
Ineffective Cardiac Tissue Perfusion
secondary to CAD as evidenced by chest
pain or other prodromal symptoms
Deficient knowledge about underlying
disease and methods for avoiding
complications
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12. Planning and Goals
Goals include immediate and appropriate
treatment when angina occurs, prevention
of angina, reduction of anxiety, awareness
of the disease process and understanding
of the prescribed care.
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13. Nursing Interventions
 Take immediate action if patient reports pain or if
the person’s symptoms suggest anginal ischemia
 Direct the patient to stop all activities and sit or rest
in bed in a semi Fowler’s position to reduce the
oxygen requirements of the ischemic myocardium.
 Measure vital signs and observe for signs of respiratory
distress.
 Administer oxygen therapy if the patient’s
respiratory rate is increased or if the oxygen saturation
level is decreased.
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14. Evaluation
 Expected Patient Outcomes
 Reports that pain is relieved
 Reports decreased anxiety
 Understands ways to avoid complications and
demonstrates freedom from complications
 Complies with self care program
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15. Medication
The most specific medicine to
treat angina is nitroglycerin
Beta Blockers and calcium
channel blockers
Aspirin.
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16. References
 "MerckMedicus: Dorland's Medical Dictionary".
Retrieved 2009-01-09.
 Jump up^ White, PD (1931). Heart Disease (1st ed.).
Macmillan.
 Jump up^ COURAGE Trial Research Group
(2007). "Optimal Medical Therapy with or without PCI for
Stable Coronary Disease". N Engl J Med 356: 1503–
1516. doi:10.1056/NEJMoa070829.PMID 17387127. Retrieved 1
December 2014.
 ^ Jump up to:a b Tobin, Kenneth J. (2010). "Stable Angina
Pectoris: What Does the Current Clinical Evidence Tell
Us?". The Journal of the American Osteopathic
Association 110 (7): 364–70.PMID 20693568.
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