ANGINA PECTORIS

INTRODUCTION:

Angina, known as angina pectoris, is chest pain which occurs due to  lack of blood flow to the muscles of heart.

DEFINITION:

It’s defined as “chest pain due to less supply of oxygen to the heart muscle, causing severe pain characterized by a feeling of pressure and suffocation behind the breastbone.

CLASSIFICATION:

1. Stable angina:- Also known as ‘effort angina’, associated by few activities such as running, walking, etc.
2. Unstable angina:-“crescendo angina”. It’s  three features:
3. occurs at rest, last >10 minutes
4.  severe, within 4–6 weeks
5. more severe, it’s prolonged.
6. Microvascular angina:- Characterized by angina-like chest pain.

ETIOLOGY:

1 Anemia

2. Abnormal heart rhythms

3. DM

4. Heart failure

5. Smoking

6. Physical inactivity

7. Obesity

8. Stress

9. HTN

10. Dyslipidemia

SIGN AND SYMPTOMS:

1. chest discomfort (heaviness, tightness, choking sensation)
2. burning
3. pain (epigastric region, back, neck, jaw, shoulders)
4. dyspnoea
5. nausea, vomiting
6. perspiration
7. anxiety

DIAGNOSIS:

Angina should be suspected in people presenting tight, dull, or heavy chest discomfort that is:-

1. pain especially on left-side which radiates to the left arm, neck, jaw, back.
2. Precipitated by cold weather.
3. ECG: at the time of pain, depression/elevation of ST-segment observed.
4.  TMT
5. HTN
6.  pulse rate
7. Coronary angiogram
8. CABG.

TREATMENT:

1. Administer O2
   • Nitroglycerin
   • Aspirin to be administered
   • Propranolol/ Metoprolol: to reduce the heart rate and blood pressure
   • Morphine sulfate 
   • Calcium channel blockers
   • Sodium channel blocker

Patient care:

1. Evaluate: Cardiopulmonary status  
2. Monitor: pain pattern OPQRST (onset, provocation, quality, region, radiation, referral, severity, time)
3. electrocardiogram 
4. A health care provider should accompany the patient throughout the process of treatment, as well as must provide emotional support 
5. encourage patient to stop smoking
6. maintain body weight
7. to lower cholesterol level
8. keep blood glucose under control 
9. limit the intake of salt 
10. exercise (walking, gardening, or swimming every day) .