Pathologic Conditions
- Definition: Transient chest pain or feeling of constriction about the heart.
- Pathophysiology: Deficiency of O2 to the heart muscle results in pain.
- Etiology: CAD; hypertension; CHF; coronary artery spasm usually precipitated by exercise, stress, exposure to cold, or a large meal. Symptoms usually last 1 to 4 minutes.
- Manifestations: Pain and/or a feeling of constriction or burning about the heart; typically radiates to the left shoulder and down the left arm, back, or jaw or rarely to the abdomen (mimics MI but does not cause cellular death).
- Med Tx: O2, vasodilators (nitrates), beta-adrenergic blockers, calcium channel blockers, rest, stress reduction programs.
- Nsg Dx: Decreased (cardiac) tissue perfusion, pain, activity intolerance, knowledge deficit, anxiety.
- Nsg Care: Assess and record details of attacks. Provide for immediate rest and quiet environment during attacks. Monitor effects of medical treatment. Eliminate precipitating factors. Provide education. Instruct the patient to seek immediate medical attention if three doses of nitroglycerin at 5-minute intervals do not provide relief.
- Prognosis: Varies. With proper rest and care, recovery is possible, but prognosis may be grave.