Pathophysiology of Angina Assignment PDF

CLINICAL SCENARIO

TABLE OF CONTENTS
MAIN BODY...................................................................................................................................1
Question 1. Explain the rationale for the ECG request................................................................1
Question 2....................................................................................................................................1
2a. Pathophysiology of angina.....................................................................................................1
2b. List two risk factors specific to Betsy....................................................................................2
Question 3. Interpretation of the ECG........................................................................................2
Question 4. Acute Coronary Syndrome central findings that potentially lead to a diagnosis of
Acute Coronary Syndrome..........................................................................................................3
Question 5. Discuss the following drugs: GTN, diltiazem and pravastatin.................................3
Question 6. Mechanism of action and use of aspirin and ticagrelor in cardiac patients..............4
Question 7. Use of morphine in ACS..........................................................................................5
Question 8. Use current research to link the increased risk of depression with chronic illness. .5
REFERENCES................................................................................................................................6

MAIN BODY
Question 1. Explain the rationale for the ECG request
The rationale for ECG request is important to identify the issues related to heart such as
irregular heartbeats, irregularity in rhythm, inadequate supply of oxygen etc. It is based on the
patient's complaint of short of breathlessness and feeling giddy. Her medical history included
coronary heart disease, chronic obstructive pulmonary disease and thus, there might be
possibility of any dysfunctionality of Betsy health conditions (Dedic & et.al., 2016). Moreover,
Betsy who is an elderly and is following medication of heavy doses including diltiazem SR,
salbutamol, spiriva and aspirin. She looked pale and sweaty and these signs indicated some
hidden symptoms and thus the nurse requested for an Electrocardiogram.
Question 2
2a. Pathophysiology of angina
Stable angina is refereed as the chest pain that takes place due to poor blood vessels in
the heart. This is the most common type of angina and occurs mostly while performing any task
or activity and goes away by taking proper rest. The patient has stable angina due to the
symptoms including nausea, sweating, paleness and shortness of breath. However, this angina is
one of the triggering factors for coronary artery disease (Saric & et.al., 2016). Thus, its causes,
progression and outcomes must be examined from time to study the onset of this disease in
patients like Betsy. However, this also initiates the onset of any heart problem and takes gradual
time to grow. Mostly, the symptoms are overlooked and it starts developing gradually by
following a set pattern and impact the patient's well being. Here the patient, Betsy had past
medical history of heart issue in the form of COPD, CAGs and hypertension.
There are several causes which consists of nausea, pain in arms, neck, shoulder, chest
pain, release of pressure or burning sensation, fatigue, sweating etc. Additionally, the stable
angina lasts for shorter duration and disappears sooner (Carlton & et.al., 2016). This is developed
during the activity or performing any task like exercising, swimming etc. and makes the heart to
work harder. Here the pain occurs but with medication or rest, it gets treated instantly. Its impact
is not lasting and might lead towards the normal adoption of healthy living. Next is the medical
emergency type, which is called as unstable angina where the affected patient is expected to any
usual change and has more severe effects. The medication has the impact that is long standing
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and might signal towards the occurrence of heart attack. This unstable angina is exactly like its
name which reflects upon the uncertainties and irregularities in terms of future impact.
STEMI is an acronym used for ST Elevation Myocardial Infarction which refers a serious
type of heart attack and is mostly treated with angioplasty or stenting via using thrombolytic or
PCI (percutaneous coronary intervention). For this, the individual is suffering from abnormalities
in the arteries gets blocked and this results in inconsistent flow of blood. Nevertheless, the
people misjudged it by dismissing it as symptoms of indigestion or heartburn. In rare cases like
Betsy who already has hypertension and undergo heavy does of medication on daily basis, the
scenario might be under controlled but with chances of getting a heart attack (Nishiguchi &
et.al., 2016). On the other hand, Non-ST Elevation Myocardial Infarction is considered as less
common than the STEMI. It has been evident that this is an intermediate form of Acute Coronary
Syndrome and is mainly due to onset of unstable angina. Here the patient takes additional
pressure that leads to damage on the muscles of the heart and might leads to tightness in the
chest, hooting pains in the arm and leg and more. Here, this is curable when treated under
supervision of professional help.
2b. List two risk factors specific to Betsy
The two risk factors that might impact Betsy with increasing risks of Acute Coronary
Syndrome are as follows. Firstly, her medication dosage which is based on daily basis and the
additional pressure on her body due to lack of physical activity (Pape & et.al., 2015). There is
past records of hypertension and past medical history of Chronic Obstructive Pulmonary
Disease. Secondly, the history of coronary heart disease and Type 2 Diabetes Mellitus also
proved another factor that risks her towards ACI. The additional signs were the symptoms of
nauseous feeling and patterns of heavy breathing which also hindered her well being.
Question 3. Interpretation of the ECG
An Electro Cardiogram is the combination of P waves, T waves and QRS complex. The
rhyme is inconsistent forms and the rate is present but shows irregularities in the p waves. This
infers that Betsy has stable angina which focuses on minute levels of abnormalities in her heart
rate despite showing fluctuations. Moreover, the sensors attached are useful in detecting the
electrical signals by the heart.
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