HPR 010 Lecture Notes - Lecture 20: Angina Pectoris, Transient Ischemic Attack, Coronary Circulation
12 Jun 2018
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Chapter 17: Sudden Illness
Unexplained Changes in Responsiveness
- People can be alert, unresponsive, or somewhere between the two. Not all responsive people
are fully alert, and they may respond too different levels of stimulation.
- Causes of Changes in Responsiveness: STOP
o S → sugar, seizures, stroke, shock → blood glucose is too low or too high
o T → temperature → too high (heat stroke) or too low (hypothermia)
o O → oxygen → inadequate oxygen
o P → poisoning, pressure on brain → drug/alcohol overdose; carbon monoxide poisoning,
head injury
Heart Attack
- Heart muscle needs oxygen to survive.
- Coronary arteries are the vessels that supply blood and oxygen to the heart muscle, myocardium.
When the blood supply is cut off, a heart attack, or myocardial infarction results.
- Blockage of blood flow occurs as the vessel walls slowly become thicker and harder due to the
buildup of plaque. This process → atherosclerosis.
o If part of the plaque breaks open, a clot can form over it, causing a sudden complete
blockage of the artery = heart attack
- Heart and blood vessel disease → Aeia’s ue oe kille.
- Difference Between Heart Attack and Cardiac Arrest
o Heart attack: when one of more of the arteries delivering blood to the heart become
blocked, so oxygen rich blood cannot reach the heart muscle and it is damages. The
damage causes distuaes of the heat’s eletial sste ad a lead to adia
arrest.
o Cardiac arrest: ous he the heat stops eatig asstole o he the heat’s loe
chambers (ventricles) suddenly develop a rapid irregular rhythm (V-fib), causing the
etiles to uie athe tha otat. This eas the heat a’t suppl the od ad
brain with oxygen rich blood and the person will suddenly become unresponsive with no
pulse. CPR and an AED can save them.
- What to Look For: chest pain like pressure, squeezing or fullness in the center of the chest;
sweating or cold sweats, dizziness, nausea or vomiting, numbness, shortness of breath, and
fatigue.
o Might not see these symptoms in women.
o Also, there is a stereotype that when women go to the hospital with these symptoms, it’s
just considered due to stress and they are told to go to a spa.
- What to Do:
o If the person takes medication (ex: nitroglycerin) for a heart condition, help them take it
o If alert, able to swallow and not allergic, help person take aspiring
o Monitor breathing, if it stops, give CPR
o Have person sit with knees raises and lean against something stable, and loosen tight
clothes
o Call 911
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find more resources at oneclass.com
Risk Factors for Heart Disease
- Factors you cannot change: heredity, sex → men have a greater risk, and age → people over 65
have a higher change of a heart attack
- Factors you can change: smoking, high blood cholesterol level, high blood pressure, diabetes,
obesity, physical inactivity, and stress.
Facts:
- One third of heart attacks give no chest pain to people
Angina
- Chest pain called angina pectoris results when blood flow to the heart muscle is restricted, but
not blocked completely.
- Angina occurs when coronary arteries supplying the heart muscle with oxygen rich blood become
narrow and cannot carry sufficient blood to meet the demands during:
o Physical exertion, excitement, emotional upset, eating a heavy meal, extreme hot or cold
temps, and smoking
- Angina can be treated with drugs that cause blood vessels to relax
o Nitroglycerin relaxes the veins and coronary arteries a little
o By relaxing the veins, it reduces the amount of blood that returns to the heart and eases
the heat’s okload.
o By relaxing the coronary arteries, it increases the heat’s lood suppl
- What to Look For: chest pain like crushing or squeezing, pain that can spread from the jaw, arms
and midback, pain lasting from 3 to 10 minutes, pain that is always relieved by nitroglycerin, pain
associated with shortness of breath, nausea, or sweating, anxiety.
- What to Do:
o Have person stop and sit down
o Take nitroglycerin
▪ Tablets or spray
o Call 911 if there is no improvement
Cause of Pain
Characteristics
Care
Muscle or rib pain from
exercise of injury
Reproduced by movement
Tender spot when pressed
Rest, aspiring or Motrin
Respiratory infection
(pneumonia, bronchitis)
Cough, fever, sore throat, production of mucus
Antibiotics
Indigestion
Belching, heartburn, nausea, sour taste
Antacids
Angina pectoris
Lasts less than 10 min (but pain feels like a
heart attack)
Rest, and medication
Heart attack (myocardial
infarction)
Lasts more than 10 min
Pressure, squeezing, or pain near center of
chest
Pain spreads to shoulders, neck, or arms
Call 911, check breathing,
resting position, prescribed
meds.
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find more resources at oneclass.com
Light-headedness, fainting, sweating, nausea,
shortness of breath
Stroke (cerebral vascular accident)
- A stroke occurs when there is a sudden interruption of blood flow to the brain. When arteries in
the brain rupture or become loked, pat of the ai does’t eeie the lood flo it eeds.
- Deprived of oxygen rich blood, nerve cells in the affected area of the brain cannot function and
die ithi iutes. Dead ai ells ae’t eplaed so the effets of a stoke ae pemanent.
- Stroke Classification:
o Ischemic stroke: occurs when blood vessels to the brain become narrowed or clogged
with fatty deposits called plaque, cutting off blood flow to the brain cells.
o Hemorrhagic stroke: about 15% of strokes happen when a blood vessel ruptures in or
near the brain.
▪ Severe headache, vomiting, and nausea are sudden symptoms
- A transient ischemic attack (TIA) (known as a little stroke) is a form of stroke that occurs when a
part of the brain is deprived of oxygen rich blood long enough to cause symptoms but not long
enough to cause permanent damage. Hard to recognize because symptoms are quick.
- What to Look For: FAST
o F: face → ask the person to smile
o A: arms → ask the person to close his or her eyes and raise both arms with the palms up
o S: speech → ask the person to repeat a simple phrase
o T: time → seek medical care RIGHT AWAY
- What to Do:
o Call 911 quickly
o Monitor breathing
o Position person on back with head and shoulders raised
o Loosen tight clothes
o Be prepared to turn person on their side
Stoke Scale
- Facial Droop – ask person to smile
o Normal: both sides of face move well
o Abnormal: one side of the face does not move
- Arm drift – ask person to close his or her eyes and hold out both arms with palms up
o Normal: both arms move the same, or both arms do not move
o Abnormal: one arm does not move, or one arm drifts down compared with the other side
- Speech: ask the person to say, The sk is lue i Cincinnati
o Normal: the person uses correct words with no slurring
o Abnormal: the person slurs words, uses iappopiate ods, o a’t speak
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
People can be alert, unresponsive, or somewhere between the two. Not all responsive people are fully alert, and they may respond too different levels of stimulation. Coronary arteries are the vessels that supply blood and oxygen to the heart muscle, myocardium. When the blood supply is cut off, a heart attack, or myocardial infarction results. Blockage of blood flow occurs as the vessel walls slowly become thicker and harder due to the buildup of plaque. If part of the plaque breaks open, a clot can form over it, causing a sudden complete blockage of the artery = heart attack. Heart and blood vessel disease a(cid:373)e(cid:396)i(cid:272)a"s (cid:374)u(cid:373)(cid:271)e(cid:396) o(cid:374)e kille(cid:396). Difference between heart attack and cardiac arrest: heart attack: when one of more of the arteries delivering blood to the heart become blocked, so oxygen rich blood cannot reach the heart muscle and it is damages. If the person takes medication (ex: nitroglycerin) for a heart condition, help them take it.
