Summary Nurs 101, chapter 38; care of patients with,coronary syndromes.

nurs 101,hudson county community college;summary of chapter 38 care of patients with coronary syndromes. carefully noted down points to help in your reading and test prep of coronary syndromes field. Coronary Artery Disease (CAD) Also known as coronary heart disease or simply heart disease ● Includes: chronic stable angina and acute coronary syndromes o What does it effect? ▪ Affects the arteries that provide blood, oxygen, and nutrients to the myocardium (heart muscle) o If blood flow through the coronary arteries are partially blocked or completely blocked what happens? ▪ Ischemia ● insufficient oxygen to meet the requirements of the myocardium ● limited in duration ● can be reversible ▪ Infarction ● necrosis of cell death ● occurs if severe ischemia is prolonged and decreased perfusion causes irreversible damage to tissue ● not reversible Acute Coronary Syndrome ● Term used to describe patient with o Unstable angina o Acute Myocardial Infarction ● What happens with this? o It is believed that atherosclerotic plaque in the coronary artery ruptures resulting in: ▪ Platelet aggregation (“clumping” ▪ Thrombus (clot) formation ▪ Vasoconstriction ● Amount of disruption caused by the atherosclerotic plaque determines the degree of coronary artery o Obstruction (blockage) ▪ ! The artery must have at least 40% plaque accumulation before it starts to block blood flow o Specific disease process Chronic Stable Angina Pectoris ● Angina pectoris 1. Chest pain caused by a temporary imbalance between the coronary arteries’ ability to supply oxygen and the cardiac muscle’s demand for oxygen. ● Ischemia 1. Lack of oxygen that occurs with angina 2. Limited in duration 3. Does not cause permanent damage of myocardial tissue ● Two types of Angina 1. Chronic stable angina (CSA) Patient’s with unstable angina present with ST changes on a 12-lead ECG but do not have changes in Troponin or Creatinine Kinase (CK) levels New Onset Angina ● Individual with his or her 1st angina symptom after exertion or other increased demands of the heart Variant (Prinzmetal’s) Angina ● Chest pain or discomfort resulting from coronary artery spasm ● Typically occurs after rest Pre-Infarction Angina ● Chest pain that occurs in the days before or weeks before an MI Myocardial Infarction Description: Sudden restriction of the blood supply to a portion of the heart. It is a potentially life-threatening condition. Most serious coronary syndrome. Referred to as acute MI or AMI Non-ST-segment elevation myocardial infarction (NSTEMI) ● ST and T wave changes on a 12 lead ECG o Indicates necrosis or cell death o Cardiac enzyme are normally initially then elevate over the next 3-12 hours