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DISEASE
ANGINA Pectoris
MYOCARDIAL INFARCTION (MI)
Presenter
Hina Karim
NES Instructor
Objectives
Types
Mechanism
Causes
Clinical manifestation
Complication
Nursing care
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Cont.
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Angina Pectoris
Definition:
Angina:
Choking or suffocation.
Pectoris:
Chest.
Angina pectoris, is the medical term
used to describe acute chest pain or
discomfort.
Angina occurs when the hearts need for
oxygen increases beyond the level of
oxygen available from the blood
nourishing the heart.
It has 3 types
Stable Angina
Un stable angina &
Variant Angina (Prinzmetals or resting
angina) :
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Cont.
Types of Angina
Stable angina:
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Cont.
Unstable angina:
It is triggered by an un
predictable degree of
exertion or emotion.
(progressive), more
severe than stable.
Characterized by
increasing frequency &
severity. Provoked by less
than usual effort,
occurring at rest &
interferes with pt
lifestyle.
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Cont.
Variant Angina
(Prinzmetals or resting
angina) :
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Mechanism Of Angina
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Causes
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Clinical Manifestations
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Investigations
Electrocardiogram ( ECG)
Coronary angiography
Exercise Electrocardiogram (Stress test).
Complications:
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Myocardial infarction
Cardiac Arrhythmias
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Myocardium Infarction
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PATHOPHYSIOLOGY
Coronary artery cannot supply enough blood to the
heart in response to the demand due to CAD
Within 10 seconds myocardial cells experience ischemia
Ischemic cells cannot get enough oxygen or glucose
Ischemic myocardial cells may have decreased
electrical & muscular function
Cells convert to anaerobic metabolism.
Cells produce lactic acid as waste
Pain develops from lactic acid accumulation
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Cont
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Collaborative Management
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Assessment:
History
Clinical manifestation
Cardiovascular assessment
Laboratory assessment
Troponin T & I
CK-MB
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Radiographic Assessment
ECG
Stress Test
Myocardial perfusion imaging
MRI
Cardiac Catheterization
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IMPORTANT INFORMATION TO
REMEMBER
Increase supply of
Oxygen
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Intervention
Medication:
Morphine Sulphate
Nitrates (GTN)
Beta blockers
Calcium Channel Blocker
Anti platelets / Anti coagulant
Thrombolytic therapy
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Surgical management
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PTCA (Percutaneous
Transluminal Coronary
Angioplasty
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Nursing Diagnosis
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Prevention
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COMPLICATIONS OF MI:
Arrhythmias
Atrial
arrhythmias.
Ventricular arrhythmias.
Bradycardia and heart block.
Asystol.
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Hypertension.
LV failure.
Cardiogenic shock.
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CARDIAC REHABILITATION:
Cardiac rehabilitation provides a venue for
continued education, re-enforcement of lifestyle
modification, and adherence to a comprehensive
prescription of therapies for recovery from MI,
which includes exercise training
activity
Lives as full, vital and productive life
Remain within the limits of the hearts ability to
respond to increases in activity and stress.
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FOLLOW UP
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