Comparison of Cardiovascular Exemplars
Comparison of Cardiovascular Exemplars:
| Angina | Acute Myocardial Infarction | |
| Pathophysiology | The condition occurs when there is an insufficient supply of blood in the myocardium, thus failing to meet the myocardium’s oxygen demand. As a result, the metabolic activities of the myocardial cells are disrupted as they shift from aerobic to aerobic activities. The most common form of ischemic myocardium is angina pectoris, which occurs due to chemical reactions and stimulations of the sensory cells in the coronary artery and the heart muscles (Silvestri, & Silvestri, 2019).
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Also known as a heart attack. The condition occurs due to the accumulation of plaques in the coronary artery, resulting in its disintegration. The rupturing of the arteries may facilitate the entry of cholesterol and other materials into the bloodstream. Blood clogs around the damaged part of the arteries and a large clot may cause obstruction, thus impairing blood flow. Obstruction of the arteries may damage the heart muscles (Silvestri, & Silvestri, 2019). |
| Etiology | Angina attacks result from an insufficient supply of oxygen in the heart due to physical exertion, stress, fatty meal, extreme temperatures, and smoking. Other causes of angina include; coronary heart diseases, high levels of carboxyhemoglobin, anemia, an increase in extravascular forces, and a decrease in the left ventricles’ diastolic pressure. Artery spasm triggered by certain risk factors and blood clots also causes angina (Silvestri, & Silvestri, 2019).
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The most common cause of heart attack is thrombosis—a clot forms inside the accumulation of the vessel’s plaque. As a result, the blood flows slowly in the coronary artery, whereas there are fast heartbeats and low blood pressure. A higher demand for oxygen that supply may also cause a heart attack. The blockage of coronary arteries causes cardiac arrhythmias. Patients with atherosclerosis are also highly likely to experience a heart attack.
Coronary artery spasm, a temporary constriction of the heart, may cause myocardial infarction (Silvestri, & Silvestri, 2019). |
| Assessment Findings (including Diagnostics)
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The most common clinical feature for angina is a retrosternal heaviness to the top of the arms, neck, shoulders, or abdomen. The patient suffers discomfort, which may be relieved by a 5-minute rest or through a glyceryl trinate. The patient suffers from chest pain. The pain intensity remains constant irrespective of the activity level.
Diagnostics include; Electrocardiogram (EKG) to check the electrical heart activities and check for any oxygen deficiency. A stress test to monitor changes in blood pressure during activities. A chest Xray to visualize the structures within the thoracic cavity, A coronary angiography to monitor activities inside the coronary artery and blood tests to monitor proteins, fats, sugar, and cholesterol levels in the heart (Gulanick & Myers, 2011).
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A physical examination for myocardial infarction patients indicates pain in the chest, jaw, shoulders, and back. The pain is temporary and only lasts for a few minutes. The patient experiences shortness of breath, is nauseous, vomits, anxious, coughs, feels dizzy, and has a high heartbeat rate.
Diagnostics include an ECG, a physical examination to monitor the heart and the blood pressure, a blood test to detect serum cardiac makers’ presence, an echocardiogram to check the functioning of the heart muscles and the valves. A radionuclide imaging to detect the obstructed parts of the coronary artery (Gulanick & Myers, 2011). |
| Nursing Diagnosis
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Inadequate cardiac tissue perfusion r/t coronary artery disease, evidenced by chest pain. | Low cardiac output r/t accumulation of plaque in the coronary artery evidenced by high blood pressure, dizziness and shortness of breath |
| Interventions (including meds and Surgical interventions)
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The angina treatment aims to reduce chest pain, prevent symptoms, and reduce the risk of a heart attack. Advise the patient to adopt healthy lifestyle behaviors like quitting smoking, weight loss, monitoring cholesterol levels, alternating resting, and physical activity, avoiding heavy meals, avoid stress, and proper dietary intake.
Pharmacological interventions include; Prescribing nitroglycerin to the patient and nitrates to reduce angina attacks. Other possible medications include; Beta-blockers, oral anti-platelet drugs, calcium channel blockers, and ACE inhibitors (Gulanick & Myers, 2011).
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Heart attack prevention may be done through regular exercises, proper dietary intake, controlling weight, smoking cessation, monitoring the blood pressure, and cholesterol levels.
Pharmacological interventions include; Prevent blood clotting by administering aspirin, oxygen therapy to promote breathing, pain management by administering morphine. Administer beta-blockers to reduce oxygen demand and nitroglycerin to facilitate blood flow and statin drugs to lower cholesterol levels. Additionally, administer heparin, which is an anticlotting factor. Reperfusion therapy may be done through a tissue plasminogen activator (tPA) Aspirin may also be administered alongside clopidogrel, prasugrel, or ticagrelor (Gulanick & Myers, 2011). |
References
Gulanick, M., & Myers, J. L. (2011). Nursing care plans: diagnoses, interventions, and outcomes. Elsevier Health Sciences.
Silvestri, L. A., & Silvestri, A. E. (2019). Saunders Comprehensive Review for the Nclex-Rn (r) Examination-E-Book. Saunders.
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