Angina Pectoris

Definition

Angina pectoris is chest discomfort resulting from temporary myocardial ischemia. When oxygen demand exceeds coronary supply. Unlike myocardial infarction, angina does not cause permanent myocardial damage.

Types

• Stable (exertional): Predictable pattern relieved by rest or nitroglycerin.
• Unstable: New onset, at rest, or worsening; considered acute coronary syndrome (emergency).
• Variant (Prinzmetal): Coronary vasospasm, often at rest or night.

Typical Presentation

Substernal chest pressure or 'elephant on chest,' radiation to left arm/jaw/back, dyspnea, diaphoresis, nausea, and anxiety lasting 5 to 15 minutes. Women, diabetics, and elderly often have atypical symptoms.

Nursing Interventions

Stop activity, assess pain and vital signs, obtain 12-lead ECG, administer nitroglycerin sublingually every 5 minutes for up to 3 doses (hold if SBP less than 90), supply oxygen if SpO2 less than 90%, and give aspirin. If pain persists beyond 15 minutes or with worsening symptoms, treat as MI.

NCLEX Relevance

Distinguish stable (predictable, relieved by rest) from unstable angina (emergency). Teach nitroglycerin storage and use (dark bottle, replace q6 months, expect headache).