Stable Angina Pectoris

The following summary is an updated case study of a 47 year old male patient, Jim who was diagnosed with Coronary Artery Disease. The patient did receive information on what CAD is and was informed that test were needed to fully diagnose and be evaluated for underlying conditions (high blood pressure, high blood cholesterol levels, diabetes and blockage. I will discuss the type of test needed for this condition and tests for any underlying conditions that are related to this disease. The type of treatment needed to control and lower his risk factor. I will also give the patient information about complementary and alternative medicine so the patient will be well informed about different types of treatment. The patient will be informed about the prognosis of the disease, and the options that the patient has to succeed in the changes in his lifestyle that are needed.

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

Heart diseases have always been the most life threatening disease to human life. This research paper focuses on one of such heart diseases, the Myocardial Infarction, in women. Throughout the paper, various reasons for its occurrence in women have been mentioned and discussion has been done on the prevention methods and treatments available for it. Moreover, this research paper aims to find methods for nurses to deal with patients suffering through this disease.

Over the past years, heart disease has constituted one of the leading causes death in America. In fact, statistics show that one in every seven deaths is as a result of heart-related diseases (American Heart Association, 2016). Conversely, most deaths reported are of elderly individuals aged above the 65 years. However, there are also other underlying conditions that elevate the risk of developing heart diseases. According to the American Heart Association (2016) 62% of men and 67.8% of women have high blood pressure that are aged between 65-74 years of age. High blood pressure exposes older people to high-risk chances of developing cardiovascular diseases, characterized by high rates of mortality, morbidity, and disability. Cardiovascular

In Focus on Pharmacology Essentials For Health Professionals, Jahangir Moini states “angina pectoris is a common form of ischemic heart disease and often precedes and accompanies MI” (Moini, 2013. p.359). When having angina, a patient will feel pressure in the chest like a squeezing sensation and the pain can travel to the jaw, down the arm, into the neck, shoulders, or back.

Heart disease is the leading killer in the United States, but is seen as a “man’s disease” even though it affects women at the same time. “When younger women do have heart attacks, though, studies have found that they are about twice as likely to die as their male counterparts — and more than 15,000 women under the age of 55 do every year.” (Dusenbery). Many women are misdiagnosed with acid reflux while having textbook heart attack symptoms of chest pain, nausea, sweating and pain radiating down their left arm simply for fitting in the ‘right demographic’ for acid reflux. Scans and tests are not done when a simple diagnosis is stated and are generally given little to no medicine before being discharged from the

CHD is the most common type of cardiovascular disease [2] and was the leading cause of death globally between 2000 and 2012 [3] – accounting for 14.6% of all deaths in Australia in 2011 (21,513 persons) and 7.8% of all disability-adjusted life years (DALYs) in Australasia in 2010 (471,550 DALYs) [4]. In 2011-12, CHD was estimated to affect 585,900 Australians, with the condition being more common in men (3.3%) than women (2.0%) and among those aged 70 and over (15% compared with 2.2% for those aged 25-69) [4]. In 2008-09 more than $2 billion was spent on CHD treatment and expenses – more than any other disease in Australia [5].

(Usually) A man collapses to the floor, purple face, following a grimace of agony, and his hand clutching his chest. For Martha Lear, that is exactly the type of heart attack her husband repeatedly suffered from—and eventually killed him. After watching him go through several of these, she believed it to be the standard heart attack normal. It wasn’t until 34 years later that her assumption was challenged—after she suffered from her own heart attack. Her symptoms didn’t match her late husband’s, she describes it as suddenly feeling vaguely unwell, feeling a flutter in her chest which rose to her throat, small pressure in her chest, nausea, chills, diarrhea, and vomiting. A mixed array of symptoms that could be something or could be nothing, symptoms were non-distinct to any layperson. Her second husband assured her it was a stomach bug. When she called her doctor and described her symptoms, he told her she should come in for an EKG the next morning but it wasn’t necessary to rush to the ER but she should come in for an EKG the next morning. She showed up for her appointment the following morning and the EKG revealed that she had a substantial heart attack the night before—stunning both her and her doctor. The differences in treatment between her and her late husband are part of a long trend of women’s cardiac disease not being recognized as easily or treated as well men’s

Chest pain is a very common symptom, and around 20% to 40% of the general population will experience chest pain in their lives(149). In the UK, up to 2 % of visits to a general practitioner are due to new onset chest pain (150). Approximately 5% of visits to the emergency department are due to a complaint of chest pain, and up to 40% of emergency hospital admissions are the result of chest pain(149, 151). Approximately 52,000 new cases of angina per year are diagnosed in men and 43,000 in women. The incidence of angina increases with age(123).

Stable angina, also known as angina pectoris, is more commonly known as chest pain. As simple as it sounds, there are many underlying causes and complications that follow along with this condition. These chest pains are most often accompanied by strenuous activities or prolonged emotional stress. Angina is closely related to coronary artery disease. Coronary artery disease leaves the arteries narrowed and restricted, which limits the flow of blood tremendously. Poor blood flow to the heart means poor oxygenation. The muscles in the heart are then oxygen deprived, which is the pain that the patient feels. The pain most often occurs when the cardiac muscles actually need more oxygen at a higher demand than usual, and when the workload on the heart has been increased. There are many conditions that increase the need for more oxygen, such as hyperthyroidism and hypertension. More often than none, rest and/or nitrates usually relieve the pain. If the pain is continuous while resting, the diagnosis can be changed to unstable angina.

“The stage of clinical disease begins when signs and symptoms are manifest” (Merrill, 2013, p. 51). Symptoms may occur differently between men and women. For example, angina and heart attack symptoms have similar warning signs however “Women are somewhat more likely than men to have other symptoms like shortness of breath, nausea, and back or jaw pain. Some women describe their symptoms as mild. Others feel tired when they have angina” (Cardiosmart.org, 2012). Women that experience heart attacks are “somewhat more likely than men to have other symptoms like shortness of breath, nausea, and back or jaw pain” (Cardiosmart.org, 2012). Responding appropriately to the clinical onset of coronary disease will determine if the patient can recover or suffer disability or death.

Angina is considered a pressure or squeezing pain that occurs in your chest area. This is usually due to your heart muscle not getting the blood it needs to the heart. The pain could also happen in your shoulders, arms, jaw, neck, and back.

Heart disease affects over five million Americans both male and female. Researchers have discovered that the differences in the growth of the heart and how diseases develop vary in males and females. Although both genders have many of the same risk factors, such as obesity, cigarette smoking, hypertension, and metabolic syndrome. Females are more likely to develop heart disease from elevated blood pressure due to menopause, having an autoimmune disease, or stress and depression. (Group, 2017)

Prinzmetal or Variant Angina is caused by a spasm in a coronary artery, that narrows the artery and causes decreased or stop blood flow to the heart, the pain is described as being unpredictable attacks. Vasospasm has been acknowledged as the plausible means leading to Variant Angina, while the cause of vasospasm is unknown. Suggested means include atherosclerosis-induced hypercontractility, abnormal calcium flux across vascular smooth muscle and abnormal secretion of vasospastic chemicals by local mast cells. The Clinical Symptoms of Prinzmetal or Variant Angina are fatigue, weakness, nausea, chest pain , and most individuals with Prinzmetal Angina have substantial coronary atherosclerosis, the initiation of ischemic symptoms is not linked to physical or emotional exertion, heart rate, or other obvious causes of greater myocardial oxygen demand. Patients with Variant Angina react well to treatment with calcium channelblocking drugs, which prevent vascular smooth muscle contraction (Copstead & Banasik, 2013, p. 385).

     People with coronary heart disease, whether or not they have had a heart attack, experience