NURS 4526 Lecture Notes - Lecture 7: Coronary Artery Disease, Isosorbide Dinitrate, Unstable Angina
Document Summary
Pain usually lasts 3 to 5 minutes: subsides when the precipitating factor is relieved, pain at rest is unusual, ecg reveals st segment depression. When ischemia is prolonged and not immediately reversible, acute coronary syndrome (acs) develops: unstable angina (ua, non st-segment-elevation myocardial infarction (nstemi, st-segment-elevation (stemi) Deterioration of a once stable plaque that stimulates platelet aggregation and local vasoconstriction with thrombus formation. Result: partial occlusion of coronary artery: ua or nstemi, total occlusion of coronary artery: stemi. Unstable angina: unpredictable and represents medical emergency. Sympathetic nervous system stimulation from catecholamines released from ischemic myocardial cells results in: release of glycogen, diaphoresis, vasoconstriction of peripheral blood vessels, skin: ashen, clammy, and/or cool to touch. Initially, (cid:313) hr and bp, then (cid:315) bp (secondary to (cid:315) in co: crackles, jugular venous distension, hepatic engorgement & peripheral edema, abnormal heart sounds, s3 or s 4, holosystolic murmur.
