Angina

• What are the two conditions of myocardial ischemia mentioned?

  Angina and Myocardial Infarction
• What occurs when the demand for oxygen exceeds the supply?

  Myocardial ischemia
• What type of ischemia is associated with Angina?

  Partial thickness of myocardial muscle
• What type of ischemia is associated with Myocardial Infarction?

  Full thickness of myocardial muscle
• What are the key differences between Angina and Myocardial Infarction?

  • Angina: Chest pain from myocardial ischemia
  • Myocardial Infarction: Death of myocardial cells
  • Angina: Relieve pain, reduce disease progression
  • Myocardial Infarction: Restore blood flow
• What causes Angina?

  Stenosis, vasospasm, thickening of heart wall
• What is the goal of treating Angina?

  Relieve pain and reduce disease progression
• What is the primary cause of Myocardial Infarction?

  Stenosis and plaque lodge
• What is the emergency status of Myocardial Infarction?

  It is an emergency
• What assessments are important for diagnosing myocardial conditions?

  • Health history and family history
  • Physical exam (vitals, cardiac exam)
  • Systems assessment
  • Labs and investigations
• What are non-modifiable risk factors for myocardial conditions?

  Family history, age, gender, genetics
• What are modifiable risk factors for myocardial conditions?

  Lifestyle, stress, alcohol, smoking, depression
• What comorbidities are associated with myocardial conditions?

  HTN, dyslipidemia, diabetes, high BMI, CHF
• What symptoms should be assessed in patients with myocardial conditions?

  Experience of symptoms and activities that relieve
• What medications might be relevant in the assessment of myocardial conditions?

  Blood thinners and nitro use
• What are the physical assessment findings in myocardial conditions?

  • Neuro: Anxiety, restlessness, dizziness
  • Respiratory: Tachypnea, crackles, SOB
  • GI: Nausea and vomiting
  • Cardiac: Chest pain, irregular rhythm, bounding pulse
  • Integumentary: Flushed, pale, diaphoretic
• What are the characteristics of stable and unstable Angina?

  • Stable: Predictable, occurs with exertion, relieved by rest/nitro
  • Unstable: Unpredictable, occurs without exertion, not relieved by rest/nitro
• What is the purpose of an Electrocardiogram (12-Lead)?

  Identify rhythm changes indicative of an MI
• What is the time frame to rule out Myocardial Infarction upon arrival?

  Within 10 minutes
• What are the diagnostic tests for Angina?

  • Troponin: ST depression, T wave inversion
  • Exercise Tolerance Test (ETT): Visualizes heart activity during exertion
  • Coronary Angiogram: Visualizes coronary blood flow
• What does Troponin indicate in myocardial conditions?

  Elevated with cardiac muscle damage
• What is the normal level of Troponin I?

  Normal = $<0.03 \text{ ng/mL}>$
• When does Troponin elevate after a Myocardial Infarction?

  Elevates 3-6 hours post MI
• How long does Troponin remain elevated after a Myocardial Infarction?

  Remains high 5-9 days
• What are the nursing priorities for myocardial conditions?

  1. Pain management & promote perfusion
  2. Minimize risk for complications
  3. Health teaching (treatment/lifestyle modifications)