Angina Pectoris Case Analysis

To determine if the patient’s chest pain is related to cardiac ischemia, you would look for ST-segment depression and/or T wave inversion. If the ST-segment depression is at least 1mm (one small box) below the isoelectric line, it is significant and occurs in response to inadequate supply of blood and oxygen, which leads to an electrical disturbance. Once this is treated, adequate blood flow is restored, the ECG changes will resolve, and the ECG will return back to patient’s baseline.

Clearly differentiate the pathophysiology of angina and myocardial infarction, including signs and symptoms. (5 marks)

Angina is associated with clinical events that can affect prognosis, for example Von Arnim et al

Chest pain is a frequent cause of emergency department presentation. Many times, chest pain can be an indicator of myocardial infarction. Yearly, about 600,000 people die of heart disease in the United States, with a total of about 700,000 having a myocardial infarction. The leading source of death for both men and women is heart disease ("Heart disease facts," 2014). Managing the challenging clinical problems of those presenting with chest pain can be demanding. While clinical judgment is imperative in managing these patients, rapid treatment protocols to evaluate risk

R: yes, patient is not going to be moving and is NPO with fluid restrictions.

Nevertheless, there is an understandable and noticeable link between circulatory related diseases and lifestyle diseases, such as Coronary Heart Disease. Coronary heart disease can occur when fatty acids, such as cholesterol in an inadequate diet, build up in the walls of the coronary artery. These fatty deposits collect minerals and harden to become a plaque. Eventually, this plaque grows and can swells up, forming an aneurism. In some cases, this aneurism may burst leading to instant death. As it continues to grow and swell up, it finally blocks the artery completely and forms blood clots. This is known as coronary thrombosis. A myocardial infarction, or in other words as heart attack, occurs when no oxygen is able to reach the coronary artery and thus it is unable to fulfil its role in providing the heart muscle with a sufficient supply of blood. Heart attacks are very common in the society nowadays, especially occurring in smokers or obesity related diseases (Millar, June 2014)

Angina pectoris is a symptom of underlying heart condition. It is characterized with symptoms such as severe pressing chest pain or heaviness radiating to the neck, jaw back and arm. The primary cause of angina pectoris is the imbalance between myocardial oxygen demand and the oxygen supplied by the coronary artery.

If you have signs and symptoms of acute coronary syndrome, your doctor may run several tests to see if your symptoms are caused by a heart attack or another form of chest discomfort. If your doctor thinks you 're having a heart attack, the first two tests you have are:

Like any other organs in our body, the heart needs a supply of blood and

     In today’s society, people are gaining medical knowledge at quite a fast pace. Treatments, cures, and vaccines for various diseases and disorders are being developed constantly, and yet, coronary disease remains the number one killer in the world.

The fibrous plaque is often elevated and protrudes into the vessel lumen, partially or completely obstructing blood flow through the artery (Ignatavicius & Workman, 2010). When the coronary arteries are unable to meet the cardiac muscle’s need for oxygen an imbalance occurs resulting in stable angina or unstable angina. With stable angina the plaque is “fixed” and is associated with chest discomfort in response to activities. Whenever the plaque that has been accumulating in the arteries ruptures the body responds by platelet aggregation, thrombus formation, and vasoconstriction as an inflammatory response known as acute coronary syndrome or unstable angina. This in turn narrows the blood vessels and can cause an increase in obstruction of the artery. Once the artery has plaque accumulation of 40%, blood flow starts being blocked. The amount of blood flow blocked through occlusion of the artery determines the disease process.

A common cause of narrow coronary arteries is atherosclerosis, a condition caused by fatty plagues, which develop in the artery walls. Angina is associated with only a temporary reduction in the heart’s blood

Coronary Artery disease is caused by damage or injury to the inner layer of a coronary artery and can be caused by a number of factors. Some of them are; smoking, high blood pressure, high cholesterol, diabetes or insulin resistance, and/or a sedentary lifestyle. After the wall of an artery is damaged it makes it much easier for fatty deposits (plaque) such as cholesterol and other fatty waste products to build up on the linings of artery walls. This process is known as atherosclerosis. If this plaque breaks or ruptures platelets will clump at the site to try and repair the artery, but this can also block the arteries which can lead to a heart attack. The main factors that place a person at risk for this disease are age, as getting older is

Current Treatment and Consideration of Evidence Base: Upon admission, patient was most-likely suspected of having ACS (acute coronary syndrome) because of CHD (coronary heart disease) (NICE, 2014c). Troponin T High Sensitivity Test was carried out to distinguish whether chest pains were because of NSTEMI or unstable angina (NICE, 2014b). This led to diagnosis of unstable angina. His current treatment with regards to drug interactions is okay, except that enoxaparin has a clinically significant interaction with aspirin (2015, p. 1199). This can be discounted for due to his condition.

784). The immune system attempts to attack the inflamed area in the artery with special white blood cells and “cells full of fatty nutrients, foam cells, begin to form there, too” (Sapolsky, 2004, p. 43). The white blood cells are unable to properly fight the affected area, and in turn, end up adding more substance to the build up. As this process continues, the affected area becomes inflamed and physically hardens. This produces a blockage in the artery and reduces blood flow, while also causing an increase in blood pressure. At this point of the atherosclerosis build up, many people, especially women, experience angina.