DD Exam 2 Review: Key Concepts and Strategies for
Success
angina - correct answer ✔✔- acute chest pain
- results from imbalance b/t cardiac workload and O2 supply to myocardial tissue
- _______ is a symptom of decrease blood supply to heart mm b/c of atherosclerosis
- types: chronic stable, resign, unstable, nocturnal, atypical, Prinz metals
chronic stable angina - correct answer ✔✔- predictable lulls of physical/emotional stress
- responds to rest or nitroglycerin
- no pain at rest and location, duration, intensity and frequency of chest pain are consistent over time
resting angina - correct answer ✔✔- chest pain that occurs at rest in supine and usually at the same time
everyday
- pain not brought on by exercise nor relieved by rest
- aka angina decubitus
unstable angina - correct answer ✔✔- abrupt change in the intensity and frequency of symptoms or
decreased threshold of stimulus such as the onset of chest pain while at rest
- most common trigger is the bursting of a cholesterol-filled plaque in the lining of the coronary artery
- may last up to 20-30 mins and progress to MI
- pain not relieved by rest or nitroglycerin --> high risk of MI
nocturnal angina - correct answer ✔✔- waken a person from sleep with the same sensation experienced
during exertion. During sleep this exertion is usually caused by dreams. This type of angina may be
associated with underlying CHF.
prinzmetal angina - correct answer ✔✔- produces symptoms similar to typical angina BUT is caused by
abnormal or involuntary coronary artery spasm rather than directly by a build up of plaque from
atherosclerosis
,- spasms periodically squeeze arteries shut and keep the blood from reaching the heart. spasms occurs
very close to blockage. about 2/3 of ppl with this type of angina has severe coronary atherosclerosis
- occurs at rest, especially in early hours of morning and can be difficult to induce by exercise
- cyclic and frequently occurs at the same time each day
- could occur in postmenopausal women who are not undergoing hormone replacement therapy, the
reduction of estrogen may cause coronary arteries to spasm
atypical angina - correct answer ✔✔- refers to unusual symptoms (e.g., tooth- ache or earache) related
to physical or emotional exertion. These symptoms subside with rest or nitroglycerin. New- onset angina
describes angina that has developed for the first time within the last 60 days.
5 GRADE ANGINA SCALE
- grade 0 - correct answer ✔✔- no angina
5 GRADE ANGINA SCALE
- grade 1 - correct answer ✔✔- light, barely noticeable
5 GRADE ANGINA SCALE
- grade 2 - correct answer ✔✔- moderately bothersome
5 GRADE ANGINA SCALE
- grade 3 - correct answer ✔✔- severe, very uncomfortable
5 GRADE ANGINA SCALE
- grade 4 - correct answer ✔✔- most pain every experienced
ANGINA
- if p! isn't relieved by rest or nitroglycerin, up to grade 3, taken at 5 min intervals --> - correct answer
✔✔- cardiac care unit
,ANGINA
- client may indicate the location of of the symptoms by doing what? - correct answer ✔✔- may indicate
location of symptoms by placing a clenched fist against the sternum.
ANGINA
- Angina radiates most commonly where? - correct answer ✔✔- to the left shoulder and down the inside
of the arm to the fingers; but it can also refer pain to the neck, jaw, teeth, upper back, possibly down the
right arm, and occasionally to the abdomen
ANGINA
- Recognizing heart pain in _______ (men/women) is more difficult because the symptoms are less
reliable and often do not follow the classic pattern described earlier.
- Many of them describe the pain in ways consistent with ______ angina, suggesting that they first
become aware of their chest discomfort or have it diagnosed only after it reaches more advanced stages.
- Some experience a sensation similar to inhaling cold air, rather than the more typical shortness of
breath. Others complain only of weakness and lethargy, and some have noted isolated pain in the
midthoracic spine or throbbing and aching in the right biceps muscle - correct answer ✔✔- women;
unstable
ANGINA
- angina is often confused with what? - correct answer ✔✔- confused with heartburn or indigestion,
hiatal hernia, esophageal spasm, or gallbladder disease, but the pain of these other conditions is not
described as sharp or knifelike.
ANGINA
- location: 80% - 90% of clients experience p! as what? - correct answer ✔✔- experience the pain as
retrosternal or slightly to the left of the sternum.
ANGINA
- duration of angina - correct answer ✔✔- as a direct result of myocardial ischemia is typically 1 to 3
minutes and no longer than 3 to 5 minutes.
- However, attacks precipitated by a heavy meal or extreme anger may last 15 to 20 minutes.
, ANGINA
- what factors relieve angina? - correct answer ✔✔- rest or nitroglycerin (a coronary artery vasodilator)
ANGINA
- screening for chest pain, a lack of objective MSK findings is always a red flag: - correct answer ✔✔-
Active range of motion (AROM), such as trunk rotation, side bending, or shoulder motions, does not
reproduce symptoms.
- Resisted motion (horizontal shoulder abduction/ adduction) does not reproduce symptoms.
- Heat and stretching do not reduce or eliminate symptoms.
angina pectoris - correct answer ✔✔- Gripping, viselike feeling of pain or pressure behind the breast
bone
- Pain that may radiate to the neck, jaw, back, shoulder, or arms (most often the left arm in men)
- Toothache
- Burning indigestion
- Dyspnea (shortness of breath); exercise intolerance
- Nausea
- Belching
myocardial infarction - correct answer ✔✔- aka heart attack, coronary occlusion, or a "coronary," is the
development of ischemia and necrosis of myocardial tissue.
CLINICAL SIGNS AND SYMPTOMS:
What condition is this?
- May be silent (smokers, diabetics: reduced sensitivity to pain)
- Sudden cardiac death
- Prolonged or severe substernal chest pain or squeezing pressure
- Pain possibly radiating down one or both arms and/or up to the throat, neck, back, jaw, shoulders, or
arms
- Feeling of nausea or indigestion
Success
angina - correct answer ✔✔- acute chest pain
- results from imbalance b/t cardiac workload and O2 supply to myocardial tissue
- _______ is a symptom of decrease blood supply to heart mm b/c of atherosclerosis
- types: chronic stable, resign, unstable, nocturnal, atypical, Prinz metals
chronic stable angina - correct answer ✔✔- predictable lulls of physical/emotional stress
- responds to rest or nitroglycerin
- no pain at rest and location, duration, intensity and frequency of chest pain are consistent over time
resting angina - correct answer ✔✔- chest pain that occurs at rest in supine and usually at the same time
everyday
- pain not brought on by exercise nor relieved by rest
- aka angina decubitus
unstable angina - correct answer ✔✔- abrupt change in the intensity and frequency of symptoms or
decreased threshold of stimulus such as the onset of chest pain while at rest
- most common trigger is the bursting of a cholesterol-filled plaque in the lining of the coronary artery
- may last up to 20-30 mins and progress to MI
- pain not relieved by rest or nitroglycerin --> high risk of MI
nocturnal angina - correct answer ✔✔- waken a person from sleep with the same sensation experienced
during exertion. During sleep this exertion is usually caused by dreams. This type of angina may be
associated with underlying CHF.
prinzmetal angina - correct answer ✔✔- produces symptoms similar to typical angina BUT is caused by
abnormal or involuntary coronary artery spasm rather than directly by a build up of plaque from
atherosclerosis
,- spasms periodically squeeze arteries shut and keep the blood from reaching the heart. spasms occurs
very close to blockage. about 2/3 of ppl with this type of angina has severe coronary atherosclerosis
- occurs at rest, especially in early hours of morning and can be difficult to induce by exercise
- cyclic and frequently occurs at the same time each day
- could occur in postmenopausal women who are not undergoing hormone replacement therapy, the
reduction of estrogen may cause coronary arteries to spasm
atypical angina - correct answer ✔✔- refers to unusual symptoms (e.g., tooth- ache or earache) related
to physical or emotional exertion. These symptoms subside with rest or nitroglycerin. New- onset angina
describes angina that has developed for the first time within the last 60 days.
5 GRADE ANGINA SCALE
- grade 0 - correct answer ✔✔- no angina
5 GRADE ANGINA SCALE
- grade 1 - correct answer ✔✔- light, barely noticeable
5 GRADE ANGINA SCALE
- grade 2 - correct answer ✔✔- moderately bothersome
5 GRADE ANGINA SCALE
- grade 3 - correct answer ✔✔- severe, very uncomfortable
5 GRADE ANGINA SCALE
- grade 4 - correct answer ✔✔- most pain every experienced
ANGINA
- if p! isn't relieved by rest or nitroglycerin, up to grade 3, taken at 5 min intervals --> - correct answer
✔✔- cardiac care unit
,ANGINA
- client may indicate the location of of the symptoms by doing what? - correct answer ✔✔- may indicate
location of symptoms by placing a clenched fist against the sternum.
ANGINA
- Angina radiates most commonly where? - correct answer ✔✔- to the left shoulder and down the inside
of the arm to the fingers; but it can also refer pain to the neck, jaw, teeth, upper back, possibly down the
right arm, and occasionally to the abdomen
ANGINA
- Recognizing heart pain in _______ (men/women) is more difficult because the symptoms are less
reliable and often do not follow the classic pattern described earlier.
- Many of them describe the pain in ways consistent with ______ angina, suggesting that they first
become aware of their chest discomfort or have it diagnosed only after it reaches more advanced stages.
- Some experience a sensation similar to inhaling cold air, rather than the more typical shortness of
breath. Others complain only of weakness and lethargy, and some have noted isolated pain in the
midthoracic spine or throbbing and aching in the right biceps muscle - correct answer ✔✔- women;
unstable
ANGINA
- angina is often confused with what? - correct answer ✔✔- confused with heartburn or indigestion,
hiatal hernia, esophageal spasm, or gallbladder disease, but the pain of these other conditions is not
described as sharp or knifelike.
ANGINA
- location: 80% - 90% of clients experience p! as what? - correct answer ✔✔- experience the pain as
retrosternal or slightly to the left of the sternum.
ANGINA
- duration of angina - correct answer ✔✔- as a direct result of myocardial ischemia is typically 1 to 3
minutes and no longer than 3 to 5 minutes.
- However, attacks precipitated by a heavy meal or extreme anger may last 15 to 20 minutes.
, ANGINA
- what factors relieve angina? - correct answer ✔✔- rest or nitroglycerin (a coronary artery vasodilator)
ANGINA
- screening for chest pain, a lack of objective MSK findings is always a red flag: - correct answer ✔✔-
Active range of motion (AROM), such as trunk rotation, side bending, or shoulder motions, does not
reproduce symptoms.
- Resisted motion (horizontal shoulder abduction/ adduction) does not reproduce symptoms.
- Heat and stretching do not reduce or eliminate symptoms.
angina pectoris - correct answer ✔✔- Gripping, viselike feeling of pain or pressure behind the breast
bone
- Pain that may radiate to the neck, jaw, back, shoulder, or arms (most often the left arm in men)
- Toothache
- Burning indigestion
- Dyspnea (shortness of breath); exercise intolerance
- Nausea
- Belching
myocardial infarction - correct answer ✔✔- aka heart attack, coronary occlusion, or a "coronary," is the
development of ischemia and necrosis of myocardial tissue.
CLINICAL SIGNS AND SYMPTOMS:
What condition is this?
- May be silent (smokers, diabetics: reduced sensitivity to pain)
- Sudden cardiac death
- Prolonged or severe substernal chest pain or squeezing pressure
- Pain possibly radiating down one or both arms and/or up to the throat, neck, back, jaw, shoulders, or
arms
- Feeling of nausea or indigestion
