ANGINA PECTORIS

Minerva A. Cobus RN, CCN

General Information
Transient, paroxysmal chest pain produced
by insufficient blood flow to the
myocardium.
Is an important warning sign for for acute
myocardial infarction.
Etiology and Pathophysiology
Commonly caused by narrowed coronary
arteries
Impaired coronary artery flow
Increased metabolic demand
When oxygen demands of the heart muscle
exceed the ability of the coronary arteries to
deliver it; Pain occurs.
Classification/types:
1. Chronic stable angina
2. Unstable angina
3. Prinzmetals (variant)
Assessment/Clinical
Manifestations
1. Pain in varying levels of severity
1. P- precipitating factors
2. Q- quality
3. R -Region and radiation
4. S Sign and symptoms
5. T- Timing and response to treatment.
2. Palpitations
3. Levins sign client clenches fist over the
sternum
4. ECG
Nursing Intervention
1. Primary goal of treatment is to relieve
pain and prevent future attacks.
2. Administer oxygen.
3. Monitor v/s, status of cardiopulmonary
function
4. Proper positioning of the client
Nursing Intervention
5. Educate client regarding, diet, medication, and
activity
6. Avoid extremes of temperature
7. Provide necessary emotional support to client
regarding required alterations in life-style
8. Instruct client to notify physician immediately if
pain occurs and persists, despite rest and
medication

Medication
1. Proper use of nitrates
1. Oral instruct to take on an empty stomach with a
full glass of water. Do not chew
2. Sublingual (SL) allow tablet to dissolve.
1. Relax for 15-30 minutes after taking the meds to prevent
dizziness
2. If no relieve w/ in 3-5 mins may repeat dose at 5 min
interval for no more than 3 doses.
3. May be taken prophylactically to avoid pain
4. Keep in tightly closed, dark glass container, avoid exposure
to air, light, and heat.
5. Carry supply at all times
6. Fresh tablets can cause slight burning under the tongue
7. Purchase new supply every 4 to 6 week.
Medication
3. Nitroglycerine Ointment (topical)
1. Topical application is used for sustained
protection against anginal attacks
2. Avoid skin contact with topical form
3. Remove all previous applications when applying
topical form
4. Rotate sites to prevent dermal inflammation
5. Avoid massaging/rubbing as this increases
absorption and interferes with the drugs sustained
action.
Medication
2. Calcium- channel blockers
3. Beta- adrenergic blockers
4. Aspirin;
5. Heparin, or other anti-clotting drugs