Analysis of Angina

Running head: ANALYSIS OF ANGINA
ANALYSIS OF ANGINA
Name of the Student:
Name of the University:
Author note:

1ANALYSIS OF ANGINA
Q1) Describe the pathophysiology (cause, progression and outcome) of Angina. Include in
your answer risk factors for Angina and the treatment options for Angina. Demonstrate links
to Jon’s case.
Angina is considered as a condition, which leads to discomfort in chest or chest pain
due to inadequate supply of blood in the heart. Angina result in insufficient amount of oxygen
in the blood, which is mainly due to thinning of coronary artery (Healthywa.wa.gov.au,
2019).
The primary cause of angina is coronary artery disease (CAD) also denoted as
coronary heart disease (CHD). Arteries are accountable for distributing oxygen-rich blood to
the heart muscle and in this condition the function of artery is effected due to narrowing of
arteries hence, restricting the heart muscle to supply adequate amount of blood. The major
cause of angina is due to mismatch in the amount oxygen demand and the blood flow
(Healthdirect.gov.au, 2019). Restriction in the quantity of blood flow to meet the oxygen
demand leads to narrowing of artery. The myocardial cells in this situation switch to
anaerobic metabolism from aerobic metabolism; leading to advanced damage of electrical,
metabolic and mechanical function. Adenosine is the major trigger for anginal pain (Kloner
& Chaitman, 2017). Hence, during the condition of ischemia, adenosine tri-phosphate (ATP)
is converted to adenosine, which is diffused to extracellular space leading in anginal pain and
dilation of artery.
In the case study, it was clear that Jon was suffering from angina as he had continuous
chest pain. Various risk factors were responsible for his condition such as (Ohman, 2016):
 Tobacco consumption- Active or passive smoking can damage the artery by either
deposition of cholesterol or by blocking the path of blood flow. In this case, Jon was a
chain smoker and used to smoke regularly for past 25 years.

2ANALYSIS OF ANGINA
 High blood cholesterol level- Cholesterol deposits in the inner walls of artery leading
to narrowing of artery throughout the patient body including heart. Excess amount of
bad cholesterol level in the artery proliferates the threat of cardiac attack and angina.
The patient was already suffering from hypercholesterolemia, a condition that
develops due to excess deposition of cholesterol in the artery (Iqbal et al., 2016).
 Hypertension- Hypertension or excessive stress increases the risk of heart attack and
angina, as excess stress will increase the blood pressure, which can narrow down the
artery.
 Background history of heart disease
 Obesity
There are various treatment approaches for angina, which include use of medication or
change in lifestyles and is recommended for the patient well-being (Giannopoulos,
Giannoglou & Chatzizisis, 2016).
 Surgery can also be an option for angina such as stenting and angioplasty in which
the doctor insert a balloon to broaden the artery in order to increase the supply of
blood.
 Medicines such as aspirin, beta-blockers, statins, ACE inhibitors and calcium channel
blockers helps to broaden the narrowed artery.
 Lifestyle change is the major part of treatment, which includes no consumption of
tobacco, consumption of low cholesterol, physical exercise, avoidance of stress and
consumption of healthy diet.
Q2) Discuss THREE types of physical nursing assessments that would be appropriate for
Jon’s complaint (excluding vital signs) you would initiate for Jon and provide a description of

3ANALYSIS OF ANGINA
each of these in the context of Jon’s complaint with rationale as to why these would be your
priority.
The three major types of physical nursing assessment that would be appropriate for Jon
complaint is chest pain assessment, stress assessment and assessment of coronary artery.
1. Chest pain assessment- Chest pain assessment is performed for the patient who are
suffering from severe chest pain and is used to detect if the pain is cardiac in nature or
not (Abid et al., 2015). The most widely used method is ‘PQRST’ pain assessment
where,
 P- Stands for provoking factors or position. This is used for locating the area of pain,
condition, which can improve or worse the pain and situation responsible for onset of
pain.
 Q- Stands for quality. This is used for describing the pain and the type of pain such as
sharp, dull ache, crushing or stabbing pain.
 R- Stands for radiation. This is used to check if the pain is radiating to any other part
of the patient body and it is detectable or not.
 S- Stands for symptoms or severity. This is used to rate the complexity or severity of
pain at a scale of ten and to determine any other additional symptom (such as nausea
or vomiting) responsible for onset of pain.
 T- Stands for time. This is used to estimate the total time of pain that the patient is
suffering and to check if the pain is continuous or intermittent (starts and stops).
Hence, chest pain assessment will determine the severity of pain and the detail nature of
pain, which was the major symptom of angina in Jon (Denn, Noonan & Condon, 2017).
2. Nuclear stress test- As the patient was suffering from hypertension i.e. excess stress,
the assessment of his stress level was important to check to determine the severity of