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What is Angina? - (answer)Angina, or angina pectoris, is often described as chest pain usually
precipitated by stress or exertion and relieved rapidly with rest or nitrates. Those with angina
report varying symptoms including chest pain categorized as squeezing while others describe the
pain like a heavy weight being placed on the chest. Angina is relatively common, and usually due
to atherosclerotic heart disease.
What is the Patho of Angina? - (answer)Angina is chest pain that is associated with decreased
blood flow or ischemia to the myocardial tissue. The decreased blood flow may be the result of
atherosclerosis or coronary artery spasm. Neural pain receptors are stimulated by accelerated
cellular metabolism, chemical changes, and imbalances
What are signs and symptoms of Angina? - (answer)- chest heaviness
- chest pressure
- squeezing or fullness Sometimes this pain radiates to the left shoulder and arm while others
report pain in the jaw.
,Generally, the attack length can range anywhere between three minutes to twenty minutes.
Attacks reported at greater than thirty minutes are concerning and could indicate the
development of acute coronary syndrome.
What lab test are needed for angina? - (answer)- Troponin
- CK-MB: to evaluate for acute coronary symptoms as well as for anemia which might be
contributing to ischemic chest pain.
- An ECG should also be obtained to rule out acute coronary syndrome.
What are pharmacological remedies for Angina? - (answer)Nitroglycerin (Drug of choice):
Nitroglycerin relaxes and widens the blood vessel promoting easier blood flow to the heart
muscle. Dosing of nitroglycerin is 0.3-0.6 mg by translingual spray or sublingual tablet every
five minutes, as indicated with a max of 3 doses in 15 minutes.
Beta-Blockers and ACE inhibitors
What is a myocardial infarction? - (answer)(Heart Attack)
,A myocardial infarction (MI) occurs when blood flow to the heart is minimized. The blockage is
most often caused by a buildup of cholesterol, which forms a plaque in the arteries that circulate
oxygenated blood flow to the myocardium. When the plaque breaks away it can form a clot,
interrupting or completely blocking blood flow and destroying a part of the heart muscle. Unlike
with an episode of angina, those experiencing a myocardial
infarction often report symptoms of pain at rest.
What is the patho of a Myocardial Infarction? - (answer)During a myocardial infarction there is
an imbalance between myocardial oxygen supply and demand. Prolonged ischemia (>30
minutes) from the lack of circulating blood flow to the myocardium results in cellular death,
further impacting the heart's ability to function. Depending on the extent of the cell death, the
heart might have decreased contractility resulting in wall function abnormalities further placing
the patient at risk for decompensation.
What are the symptoms of a Myocardial Infraction? - (answer)- Sharp radiating pain (Even at
rest)
- Light-headed or have increased feelings of anxiety or impending doom.
- Nausea (more common in right coronary artery occlusion)
- Vomiting
- Diaphoresis
- Syncope
, - Dyspnea
- Orthopnea
- Wheezing
What lab test are needed for a Myocardial Infraction? - (answer)- Troponins
- CK-MB
- An ECG will often demonstrate ST-segment elevation or new left bundle
branch block.
How do you manage a Myocardial Infraction? - (answer)Patients presenting with acute
myocardial infarction will need reperfusion therapy or fibrinolytic therapy. To decrease mortality
rates, reperfusion through PCI needs to be completed within 90 minutes of presentation to the
emergency room.
What is Atherosclerosis? - (answer)a disease of the arteries characterized by the deposition of
plaques of fatty material on their inner walls.
What is the path of Atherosclerosis? - (answer)Atherosclerosis is an inflammatory process that
begins with damage to the endothelium often the result of hypertension, smoking, high