Coronary artery disease involving native heart with angina pectoris

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What is coronary artery disease involving native coronary artery of native heart with angina pectoris?
What does coronary artery disease in native artery mean?
Is angina pectoris the same as coronary artery disease?
Is angina pectoris serious?

Instruct patient to notify nurse immediately when chest pain occurs. Pain and decreased cardiac output may stimulate the sympathetic nervous system to release excessive amounts of norepinephrine, which increases platelet aggregation and release of thromboxane A2. This potent vasoconstrictor causes coronary artery spasm, which can precipitate, complicate, and/or prolong an anginal attack. Unbearable pain may cause vasovagal response, decreasing BP and heart rate. Assess and document patient response to medication. Provides information about disease progression. Aids in evaluating effectiveness of interventions, and may indicate need for change in therapeutic regimen. Identify precipitating event, if any: frequency, duration, intensity, and location of pain. Helps differentiate this chest pain, and aids in evaluating possible progression to unstable angina. Observe for associated symptoms: dyspnea, nausea and vomiting, dizziness, palpitations, desire to micturate. Decreased cardiac output (which may occur during ischemic myocardial episode) stimulates sympathetic and parasympathetic nervous system, causing a variety of vague sensations that patient may not identify as related to anginal episode. Evaluate reports of pain in jaw, neck, shoulder, arm, or hand (typically on left side). Cardiac pain may radiate. Pain is often referred to more superficial sites served by the same spinal cord nerve level. Place patient at complete rest during anginal episodes. Reduces myocardial oxygen demand to minimize risk of tissue injury. Elevate head of bed if patient is short of breath. Facilitates gas exchange to decrease hypoxia and resultant shortness of breath. Monitor heart rate and rhythm. Patients with unstable angina have an increased risk of acute life-threatening dysrhythmias, which occur in response to ischemic changes and/or stress. Monitor vital signs every 5 min during initial anginal attack. Blood pressure may initially rise because of sympathetic stimulation, then fall if cardiac output is compromised. Tachycardia also develops in response to sympathetic stimulation and may be sustained as a compensatory response if cardiac output falls. Stay with patient who is experiencing pain or appears anxious. Anxiety releases catecholamines, which increase myocardial workload and can escalate and/or prolong ischemic pain. Presence of nurse can reduce feelings of fear and helplessness. Maintain quiet, comfortable environment. Restrict visitors as necessary. Mental/emotional stress increases myocardial workload. Provide light meals. Have patient rest for 1 hr after meals. Decreases myocardial workload associated with work of digestion, reducing risk of anginal attack. Provide supplemental oxygen as indicated. Increases oxygen available for myocardial uptake and reversal of ischemia. Administer antianginal medication(s) promptly as indicated:

Nitroglycerin: sublingual (Nitrostat), buccal, or oral tablets, metered-dose spray.

Nitroglycerin has been the standard for treating and preventing anginal pain for more than 100 yr. Today it is available in many forms and is still the cornerstone of antianginal therapy.

sublingual isosorbide dinitrate (Isordil)

Rapid vasodilator effect lasts 10–30 min and can be used prophylactically to prevent, as well as abort, anginal attacks.

Sustained-release tablets, caplets: (Nitrong, Nitro Cap T.D.), chewable tablets (Isordil, Sorbitrate), patches, transmucosal ointment (Nitro-Dur, Transderm-Nitro)

Long-acting preparations are used to prevent recurrences by reducing coronary vasospasms and reducing cardiac workload. May cause headache, dizziness, light-headedness, symptoms that usually pass quickly. If headache is intolerable, alteration of dose or discontinuation of drug may be necessary. Note: Isordil may be more effective for patients with variant form of angina. Reduces frequency and severity of attack by producing continuous vasodilation.

Beta-blockers: acebutolol (Sectral), atenolol (Tenormin), nadolol (Corgard), metoprolol (Lopressor), propranolol (Inderal)

Reduces angina by reducing the heart’s workload. Note: Often these drugs alone are sufficient to relieve angina in less severe conditions.

Calcium channel blockers: bepridil (Vascor), amlodipine (Norvasc), nifedipine (Procardia), felodipine (Plendil), isradipine (DynaCirc), diltiazem (Cardizem)

Produces relaxation of coronary vascular smooth muscle; dilates coronary arteries; decreases peripheral vascular resistance.

Analgesics: acetaminophen (Tylenol)

Usually sufficient analgesia for relief of headache caused by dilation of cerebral vessels in response to nitrates.

Morphine sulphate (MS)

Potent narcotic analgesic may be used in acute onset because of its several beneficial effects, e.g., causes peripheral vasodilation and reduces myocardial workload; has a sedative effect to produce relaxation; interrupts the flow of vasoconstricting catecholamines and thereby effectively relieves severe chest pain. MS is given IV for rapid action and because decreased cardiac output compromises peripheral tissue absorption. Monitor serial ECG changes. Ischemia during anginal attack may cause transient ST segment depression or elevation and T wave inversion. Serial tracings verify ischemic changes, which may disappear when patient is pain-free. They also provide a baseline against which to compare later pattern changes.

What is coronary artery disease involving native coronary artery of native heart with angina pectoris?

Coronary artery disease (CAD) is a condition that affects your coronary arteries, which supply blood to your heart. With CAD, plaque buildup narrows or blocks one or more of your coronary arteries. Chest discomfort (angina) is the most common symptom.

What does coronary artery disease in native artery mean?

Coronary artery disease is caused by plaque buildup in the wall of the arteries that supply blood to the heart (called coronary arteries). Plaque is made up of cholesterol deposits. Plaque buildup causes the inside of the arteries to narrow over time. This process is called atherosclerosis.

Is angina pectoris the same as coronary artery disease?

Angina is a symptom of coronary artery disease. Angina is also called angina pectoris. Angina pain is often described as squeezing, pressure, heaviness, tightness or pain in the chest. It may feel like a heavy weight lying on the chest.

Is angina pectoris serious?

Angina is chest pain caused by reduced blood flow to the heart muscles. It's not usually life threatening, but it's a warning sign that you could be at risk of a heart attack or stroke. With treatment and healthy lifestyle changes, it's possible to control angina and reduce the risk of these more serious problems.