Angina and Acute Coronary Syndrome Overview

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Questions and Answers

What is a common initial assumption of someone experiencing chest pain for the first time?

  • It indicates a heart attack
  • It is due to indigestion (correct)
  • It is related to a respiratory issue
  • It is a symptom of anxiety

Which of the following symptoms is associated with sympathetic nervous system (SNS) stimulation due to acute myocardial ischemia?

  • Diaphragmatic irritation
  • Elevated cardiac enzymes
  • Bradycardia
  • Cool and clammy skin (correct)

What is the minimum duration of chest pain that may indicate a serious condition such as myocardial infarction?

  • Over an hour
  • 15 to 20 minutes (correct)
  • 5 to 10 minutes
  • 30 to 40 minutes

Which complication is NOT typically associated with acute myocardial infarction (AMI)?

<p>Thromboembolism (B)</p> Signup and view all the answers

Which mechanism can lead to elevated WBC count and increased body temperature during an acute myocardial infarction?

<p>Inflammatory reaction from tissue necrosis (B)</p> Signup and view all the answers

What is the typical duration of anginal pain?

<p>2 to 5 minutes (A)</p> Signup and view all the answers

Which symptom is least likely to be associated with angina in females?

<p>Severe chest tightness (A)</p> Signup and view all the answers

What pattern does anginal pain typically follow?

<p>Crescendo–decrescendo (D)</p> Signup and view all the answers

Which of the following classes of angina indicates the most severe limitations on physical activity?

<p>Class IV (B)</p> Signup and view all the answers

How long does chest pain associated with acute coronary syndrome (ACS) typically last?

<p>10 to 20 minutes (B)</p> Signup and view all the answers

What is a common descriptor of chest pain associated with acute myocardial infarction (AMI)?

<p>Crushing (B)</p> Signup and view all the answers

In contrast to angina, how is the chest pain in acute myocardial infarction characterized?

<p>Sudden onset and continuous (D)</p> Signup and view all the answers

Which symptom is not associated with acute coronary syndrome?

<p>Urinary retention (C)</p> Signup and view all the answers

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Study Notes

Angina

  • Cardinal manifestation: chest pain
  • Common triggers: physical activity, strong emotions, stress, heavy meals, exposure to cold
  • Classic sequence: activity - pain, rest - relief
  • Pain descriptors: tightness, squeezing, heavy pressure, constricting sensation
  • Pain location: beneath the sternum, radiating to jaw, neck, shoulder, or arm, less commonly in the jaw, epigastric region, or back
  • Pain pattern: crescendo-decrescendo, lasting 2-5 minutes, generally relieved by rest
  • Other manifestations: dyspnea, pallor, tachycardia, anxiety, fear
  • Severity classes:
    • Class I: occurs with strenuous or prolonged exertion
    • Class II: develops with rapid or prolonged walking or stair climbing
    • Class III: significantly limits ordinary physical activities
    • Class IV: occurs with minimal exertion or at rest

Acute Coronary Syndrome (ACS)

  • Cardinal manifestation: substernal or epigastric chest pain
  • Pain radiation: neck, left shoulder, left arm
  • Pain duration: at least 10-20 minutes
  • New onset or increasing frequency and severity of anginal pain
  • Other symptoms: dyspnea, diaphoresis, pallor, cool skin, tachycardia, hypotension, nausea, dizziness

Acute Myocardial Infarction (AMI)

  • Cardinal symptom: chest pain, more severe than angina pain
  • Pain onset: sudden, not usually associated with activity, continuous
  • Common occurrence: early morning
  • Chest pain descriptors: crushing, severe, tightness or burning, heavy pressure, squeezing sensation
  • Pain location: center of the chest (substernal), radiating to shoulders, neck, jaw, or arms
  • Pain duration: more than 15-20 minutes, not relieved by rest or nitroglycerin
  • Other symptoms: anxiety, tachycardia, cool, clammy, mottled skin, tachypnea, elevated temperature, increased WBC count, cardiac enzyme release, hyper- or hypotension, heart failure, nausea, vomiting, bradycardia, hypotension, hiccups, sudden death
  • Importance of prompt medical attention: first hour after onset of chest pain is a time of increased risk for sudden death
  • Complications: dysrhythmias, pump failure, cardiogenic shock, infarct extension, structural defects, pericarditis, Dressler syndrome

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