Angina: Pathophysiology, Treatment, and Nursing Interventions

Running Head: ANGINA 0
Case Study
Essay

ANGINA 1
1.1 Pathophysiology of angina
Angina is chest discomfort or pain caused by reduced blood flow to the heart muscle,
usually associated with coronary heart disease. Treatment primarily involves symptom relief
through rest and use of angina medications, as well as lifestyle changes to improve overall
heart health. It can be caused by underlying coronary artery disorder. When the cholesterol
aggregates are there on the walls of the artery and result in plaques form, ultimately it results
in contraction of the artery (Kones, 2010). The progressive frequency or the prolongation of
angina episodes, reduces exercise thresholds, a requirement for augmented nitro-glycerine
dosing, and lengthier recovery period all the symptoms for the physician to diagnose further.
Uncontrolled angina may results in severe chest pain, squeezing, nausea, sweating, dizziness,
shortness for breathing, and anxiety. In more severe cases it can also lead to death (Norton,
Georgiopoulou, Kalogeropoulos, & Butler, 2011). Risk factors associated with angina include
unhealthy cholesterol levels, tobacco smoking, high blood pressure, diabetes, being
overweight, sedentary lifestyle, being over 45 years old, lack of physical activity, stress and
anxiety, sleep deprivation, and family history (Kones, 2010).
Treatment
In mild cases, lifestyles changes can be helpful to control angina. Some of the lifestyle
changes are; stop smoking, losing weight, healthy diet, exercise, avoiding stress events and
limiting the alcohol consumptions (Samim, Nugent, Mehta, Shufelt, & Merz, 2010).
The physician may prescribe medicines that control the progression of these health
conditions. Medicines like nitrates, aspirin, clot-preventing drugs like clopidogrel, beta
blockers, statins, calcium channel blockers, blood pressure lowering medications, and
ranolazine can be used in issues associated with angina (Tarkin, & Kaski, 2013).

ANGINA 2
Lifestyle changes and medicine are often applied to address stable angina. If both the
above treatment does not work, in case, the medical processes like stenting, angiography, and
coronary artery bypass operation can be used to deal with angina issues (The, 2015). Jon has
been prescribed with metoprolol, pravastatin, aspirin, and glyceryl trinitrate spray. He is also
provided with cefazolin 2g TDS IV for cellulitis issues.
Some of the preventive strategies can be implemented in the case of Jon are quitting
smoking, treating the known issues like hypertension, hypercholesterolemia and cellulitis,
avoiding the known triggers of angina such as overeating, regular exercise, maintain a
favourable or healthy weight, managing blood sugar level and learning about how to manage
the mental stress that may leads to angina disorder. As mentioned in the case study Jon has
been facing a lot of additional health issues, therefore his regular vital assessment should be
done.
1.2 Nursing assessment
The patient has been complaining about the severe pain issues, he is experiencing
after the taking shower. The viral sign of Jon’s indicated that his body temperature is normal,
and irregular pulse of 110 bpm, the pressure was 110/90, respiration rate reported 24 and
oxygen saturation rate was 93 Per cent at room environment. His temperature was 37.9
degree Celsius. The chest pain during the treatment period of angina might make nurses
nervous as it can enhance chances of cardiac arrest and other cardiovascular issues. But it is
also possible that the pain occurs due to indigestion, any innocuous issues, or muscle strain.
First assessment
First of all the nurse should asses the position of the pain and try to find out the
answer of some queries like where is the pain, can patient point it, what cause the pain more

ANGINA 3
worse, what can be done, and is pain reduces or increases with repositioning (Zetta, Smith,
Jones, Allcoat& Sullivan, 2011). Sometime the positioning might cause chest pain it may be
indicated that the pain is associated with the musculoskeletal, pericarditis I in which the pain
is reduced by taking rest by setting and leaning forward), or pleuritic (Rodrigues, Moraes,
Sauer, Kalil, & de Souza, 2011). As Jon discussed that the pain occurs after taking shower,
therefore it might be possible that he is facing the problems due to changed position.
Second assessment
The severity of the pain should also be assessed by using the pain assessment rating
scale. Accompanying the symptoms of angina might also include vomiting and nausea. The
diseased person may also face dizziness, hypotension and also reduced heart rate and feeling
scared. If the pain is recognized to be very severe, the patient should be referred to the
emergency department as it might be possible that he will be experience cardiac attack
(Nezamzadeh, Khademolhosseini, Mokhtari Nori, & Ebadi, 2012). Mr Jon is an old male, so
it is possible that severe pain might be life threatening for him.
Third assessment
The time of pain should also be examined by assessing how long the pain remains and
is the pain is intermittent, means is the pain starts and stops at regular intervals or it
continues. This because the angina attacks typically occur for 2 to 5 minutes and sometimes
occurs for up to thirty minutes (Oriolo, & Albarran, 2010).
1.3 Nursing intervention
First intervention
Chest pain is the major symptom in angina and it might be low or extreme. The severe
might also be associated with the occurrence of cardiovascular diseases. First of all the