INTRODUCTION
Physical health conditions refer to chronic issues affecting an individual's health, encompassing both communicable and non-communicable diseases. These conditions often present as specific symptoms or signs of underlying diseases (Hamilton-Westa et al., 2018). This report focuses on a case study of Mr. Fred, a 75-year-old recently diagnosed with cardiovascular disease, which has led to episodes of angina. The assignment will explore major acute and chronic physical illnesses, including the causes and symptoms of angina, and will describe the primary medical interventions used in treating this condition
MAIN BODY
Demonstrate an understanding of angina
Angina describes the chest pain, discomfort ache or other connected symptom which occurred when blood flow to heart muscle cells in not enough to meet desired energy levels. It include classic description of angina that it is a kind of crushing, pain, and pressure that radiates symptoms across chest, few times down the arm, into neck, jaw or teeth and back. There are various kinds of of symptoms of angina which are evaluated including chest pain, squeezing, burning, ache in arms, nausea, fatigue, shortness, sweating and dizziness. At the other hand, it is also analyse that angina can be classified into three categories such as stable, unstable and Prinzmetal's (variant). In given scenario, Mr. Fred has been diagnosed with cardio vascular disease which has caused him to have episodes of angina recently.
Classification of Angina
Stable or chronic angina – This condition can be observed while heart is working harder that normal for instance or during exercise (Oh and Cho, 2015). It occurs for short period of time around for 5 minutes or less than that. Moreover, it is not much harmful and easily get disappears very soon by taking rest or use desired medication.
Unstable angina – The unstable angina refers to an emergency situation as it does not follow regular pattern and it is strong indication of occurring heart attack in future within a short duration of time i.e. hours or weeks. However, it involves occurs even at rest, unexpected and may become more critical for around 30 minutes or longer period of time. At the other hand, it requires strong medication including therapies or surgical procedures to solve properly.
Variant and microvascular angina – This kind of angina mostly occur when an individual is resting and usually create much severe condition of patient. It may or may not be relived by providing an effective as well as efficient treatment of angina (Leung and et. al., 2016).
Angina is caused due to narrow blood vessels which create problem in desired amount of supply of oxygen to cells. It is also known as angina pectoris which usually describes about signs of squeezing, pressure, heaviness, tightness or pain in chest of an individual. However, it include several facts relevant angina i.e. it is not a disease itself but symptom of heart problem and attacks are occurred due to decreased oxygen in blood reaching the heart. Moreover, it also involves several signs like tightness & difficulty in taking breathe and medications may differ as per different lifestyle of patients. According to case of Fred, he has habit of smoking and extra eating which plays an important to role for treating his cardio vascular disease in proper manner. He is required to avoid habit of smoking and extra eating along with putting efforts to maintain his body weight to reduce issues angina due to cardiovascular disease.
Pathophysiology of Angina – This involves about connection angina with obstruction of at least a single major artery. It also includes that lack of completing actual needs of oxygen which is normally extract from coronary circulation in order fulfil the regular demands of the same. Meanwhile, increased demand is also analysed due to which flow of arteries are required to be improved properly. Moreover, a severe condition is occur which is known as ischaemia due to blockage in coronary artery and flow is not able to improved which may results into necrosis or myocardial infarction (Al-Maweri and Zimmer, 2015). In case of Fred, his medical situation about cardiovascular disease can be diagnosed by several methods including Electrocardiogram (EKG), stress test, chest X-ray, coronary angiography and blood tests.
Causes – There are several causes of angina can be consider physical exertion, exposure to cold, eating heavy meal, stress and many more. These overall causes have their own medical reasons such as increasing myocardial oxygen demand, vasoconstriction & elevated blood pressure die improved oxygen requirements, mesenteric area of digestion, release of catecholamines due to increased blood pressure, heart rate, and myocardial workload.
Treatment for Angina – There are different types of treatment or diagnosing procedures available in medical science but they can be applied as per actual symptoms of different patients. Moreover, it can consider Angioplasty & stenting, effective medications like aspirin, nitrates, Beat blockers, Statins, Calcium channel blockers, Ranolazine (Ranexa), Angiotensin-converting enzyme (ACE) inhibitors. Furthermore, it also involves Enhanced external counter pulsation therapy (EECP) therapy and several changes in lifestyle to reduce severe impacts on health (Trinanda, Setijadi and Priyana, 2015). According to case of Mr Fred, he had advised to change his lifestyle by focussing on various factors such as smoking, poor diet, high cholesterol, lack of physical activity, excess weight, underlying situations and stress.
Angina is considered as a severe chest pain which is occurred due to reduced blood flow to the heart muscles. It's doesn't indicate the life end but it shows that life could be at risk because of this heart issue. There are several habits of daily life which should be avoided by Mr Fred to get rid of cardio vascular disease and gain healthy life are explained further –
Smoking – It is already being warned on the packets of cigarette that to avoid it. It is injurious for health. So, doctors always warned to their patients to stay away of it. It causes severe lung problems.
Poor diet – It is been prescribed by the doctor and dietician many times to have proper meal with a limited amounts of saturated fats, trans fat, and salt. Although variety of fruits and vegetables, whole grains, lean meats and low fat dairy products should be taken in case of avoid any disease even it angina.
High cholesterol - It is essential in now a days to have regular check-up of cholesterol because when it increases creates, problem. This is why it should be balanced. Several of things will be advised by doctors to apply in their daily life life ,like morning exercise , healthy and non oily food etc.
Lack of physical activity – Physical exercise plays a vital role in anyone's life because when a body can consume variety of diets and will not balanced it then it will create problem inside the heart of a human body (Kil and Shin, 2014). So , it is very important to have a balanced diet and have a proper physical exercise to run the body function appropriate. It can be done by simply walking in morning or evening. Innovation of technology into our day to day life keeps our work easy but in the same time they making us lazy and this why people generally avoid to do the task which requires manpower and prefer to do the job by the help of technology and machines.
Excess weight – Excess weight creates many serious problem and heart problem are one of that. Heart is one of the main part of human body, through which a body works. But due to excessive weight heart compress and start working slowly which is one of the reason of problems. People should start doing exercise and yoga's whatever that will be possible for them to do. And can feel the difference (Zainal And et. al., 2016).
Underlying conditions – Increased problem is the main reason of alteration risk in angina which will be as diabetes, high blood pressure and high blood pressure and high blood cholesterol.
Stress – Now, this is very common issue of now a days. Every one has a reason to disappoint. Not one is satisfied enough to bring the smile on face. And this cause many problem which people have no idea. Some times they suffered from mental issues and sometimes it cause heart issues. Both are dangerous problem which might be the reason of death. So, it should be avoided and people should try to move on with positive thoughts and process.
Discuss the main medical interventions used in the treatment of angina
The medical professionals are required to thoroughly investigate about various factors causing health problems before initiating treatment procedure. It is necessary to conduct an appropriate check up of an individual to evaluate several components. However, it includes location of pain, features of ache, medical history, pain scale, onset & cause of pain, measures that relieve ache and all another signs occurred with pain. As per case study, Mr Fred has been diagnosed for cardio vascular disease recently and his GP advised him to make several changes in his lifestyle with taking proper medications to solve the problem in accurate way. In order to provide treatment of angina, several interventions are required to be fulfilled in given case by establishing more effective as well as efficient plan of action to achieve desired outcomes (Vettriselvan and Ruben, 2018).
The nursing interventions for patient with angina pectoris can consider several factors such as treating angina, reducing anxiety, preventing pain and decreasing oxygen demand. At the other hand, it involves certain main objectives including immediate treatment, prevention of angina, reducing anxiety, awareness about disease process, adherence to self care program and absence of complications. The nursing plan with interventions and its rationale is given below –
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Interventions |
Rationale |
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Provide instructions patients in respect of immediately give notice to nurse while feeling pain. |
The reduced cardiac input or ache may regulate sympathetic nervous system to release extra amount of norepinephrine for improving platelet aggregation along with extraction of thromboxane A2. This efficient vasoconstrictor cause artery spasm responsible for precipitation, complexity or prolong an anginal attack and intolerable ache may results into vasovagal response, reducing B.P and heart rate (Blackett, George and Wilson, 2018). |
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Thoroughly check symptoms and response to patient and record them for providing further medication appropriately. |
It will help to gain actual information about situation of disease and facilitate to know about effectiveness of treatment along with indicating need for change in therapeutic regimen. |
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Determine several events of precipitation such as frequency, duration, intensity and location of pain. |
It is supportive to differentiate symptoms to evaluate specific disease in order to prevent progression to unstable angina. |
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Analyse connected signs or symptoms which can include dyspnea, nausea and vomiting, dizziness, palpitations, desire to micturate. |
Reduce cardiac outcomes in order to stimulate sympathetic and parasympathetic nervous system which can cause several types of vague sensations due to which an individual is not able to determine as relevant to anginal episode. |
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Conduct check of several parts of body to evaluate reports of pain in jaw, neck, shoulder, arm or hand (generally observed in left side). |
This involves that pain is usually describes to more superficial site which are released by similar spinal chord nerve level as the cardiac ache is radiate. |
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Provide instruction to patients for taking complete rest at the time of suffering from anginal episodes. |
It will provide help to decrease myocardial oxygen demand to minimize risk of injuries in tissues. |
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Provide facility including elevate head of bed in case if patient is suffering problem of short of breathe. |
Render help to encourage gaseous exchange in respect of reducing hypoxia and resultant shortness of breath. |
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Always remember to monitor heart rate and rhythm on regular basis. |
The people having problem of unstable angina are observed to bear increased risk of acute life threatening dysrhythmias which happen in response to ischaemic modifications or stress. |
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Required to monitor certain vital symptoms of patient by checking them in every 5 minutes at the time of initial anginal attack. |
It is observed that usually blood pressure may increase in initial time due to the reason of sympathetic simulation and then fall in case of cardiac outcome is compromised. In addition to this, tachycardia also develops on response to sympathetic regulation as a compensatory effect if cardiac outputs falls. |
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Patient should be remain under observation for 24 hours who is experiencing pain or appears anxious. |
The anxiety extracts catecholamines which is responsible for increasing myocardial workload and can escalate or prolong ischaemic pain and it is analysed that presence of medical professional will help to decrease feelings of fear as well as helplessness. |
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Policies of maintaining quite and comfortable environment along with reducing visitors should be implemented. |
It is essential for reducing mental and emotional stress which is responsible for myocardial workload. |
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Give patients light meals and instruct them to take at least 1 hour rest after eating (Lang, 2014). |
Reduce myocardial work load which are relevant to work of digestion, decreasing risk factors that can cause anginal attack to an individual. |
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Provide supplemented oxygen to patient as per indications of senior professional so that proper amount of oxygen can be supplied in desired cells of body. |
It include the criteria of boosting up oxygen available for myocardial uptake and reversal of ischaemia. |
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Antianginal medications |
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Nitroglycerin – sublingual (Nitrostat), buccal or oral tablets, metered dose spray. |
It is helpful treating anginal pain for more than 100 years and use in antianginal therapy. |
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Sublingual isosorbide dinitrate (Isordil) |
This medicine has rapid vasodilator impacts within 10 to 30 minutes and useful to prevent and abort anginal attacks. |
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Sustained- release tablets, caplets – It involve Nitrong, Isordil, Nitro Cap T.P. Sorbitrate and transmucosal ointment like Nitro-Dur & Transderm-Nitro. |
Helpful to decrease coronary vasospasms and reduce cardiac work load. Moreover, Isordil can be consider as much effective for people with variant form of angina along with decreasing criticality of attack by producing regular vasolidation. |
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Beta- blockers :- It include basically acebutolol (Sectral), atenolol (Teronin), nadolol (Corgard), Metoprolol (Lopressor) and propanolol (Inderal). |
Decrease issue of angina with the help of reducing work load of heart and these drugs are sufficient alone to solve this problem in less critical situations. |
CONCLUSION
The report concludes that angina is a severe chest pain resulting from reduced blood flow to the heart. It can be triggered by factors such as physical exertion, exposure to cold, eating heavy meals, and stress. There are various types of angina, including stable (chronic), unstable, and variant, each requiring specific medications based on the severity of the condition.
Treatment options include Angioplasty & stenting, and medications like aspirin, nitrates, beta-blockers, statins, calcium channel blockers, Ranolazine (Ranexa), and Angiotensin-converting enzyme (ACE) inhibitors. Additionally, lifestyle changes are essential in managing the condition, such as quitting smoking, improving diet, lowering cholesterol, increasing physical activity, and managing weight to prevent cardiovascular disease.
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