Angina refers to the condition where the chest experiences some level of discomfort due to poor flow of blood through the blood vessels, mostly coronary vessels of the myocardium (heart muscles). Insufficient blood flow across the heart muscles is a clear sign that there is insufficient oxygen within the heart muscles. Angina pains are usually triggered by emotional stress or physical activity (Roth, 2017). Angina pectoris is another name for stable angina. Hypertension, known as high blood pressure, can result in chronic complications thus elevates the risks of stroke, heart disease and death (MacGill, 2017).
Considering John’s history as well as his physical examinations, the diagnosis, which would be most appropriate for him would be diltiazem and lifestyle. Diltiazem is the most preferred treatment for hypertension and angina (University of Illinois-Chicago, 2017). Diltiazem treatment is given in order to relax blood vessels and the muscles of the heart because it has calcium channel breaking aspect. By relaxing the blood vessels and the muscles of the heart, the pressure that is present in the blood vessels is also reduced (University of Illinois-Chicago, 2017). When it comes to lifestyle, change is always the recommended remedy. John changing his lifestyle would help curb his stable angina. For instance, by exercising on a regular basis, and eating healthy (fruits, and vegetables) among others, would help reduce the instances of his condition (Roth, 2017).
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The Difference between a Stemi and Non-Stemi
Non-STEMI refers to non-ST segment elevation myocardial infarction while STEMI refers to ST-segment elevation myocardial infarction. The STEMI heart attack compared to the non-STEMI heart attack is more damaging (Olsen, 2017). The STEMI heart attack occurs due to the coronary artery’s complete blockage. STEMI attacks carry plenty of risks including disability and death. Partial blocking of blood arteries may result in a reduced level of blood flow thus leading to the occurrence of a non-STEMI heart attack. On an electrocardiogram (ECG), which is used in the detection of both non-STEMI and STEMI conditions of the heart, different characteristics between non-STEMI and STEMI can be seen. For instance, the non-STEMI condition has no progressing on to the Q wave, but on a STEMI condition, there is a progression to the Q wave. Also, in the non-STEMI condition, the coronary artery is partially blocked and in a STEMI condition, the coronary artery is fully blocked (Olsen, 2017).
Pathophysiological Findings Specifying an MI
MI (Myocardial Infarction) refers to the sudden ischemic myocardial tissue’s death. Diagnosing myocardial infarction in a clinic would solely depend on the symptoms, biochemical markers (serum, creatine kinase-MB, creatine kinase, and troponin), and electrocardiographic findings (Pasotti, 2006). Syndromes of acute ischemic are currently classified under unstable angina or the non-STEMI condition as well as syndromes of acute ischemic having STEMI (Pasotti, 2006). Marking and criteria of diagnosing are resulting to an increased acute ischemic proportions syndromes being identified like acute Myocardial Infarction. The occurrence of MI can be in a range of non-cardiac and cardiac disorder such as septic or sepsis shock, and pulmonary embolism among others. Acute MI diagnosis depends on the grouping of all biochemical and clinical tools, giving their individual diagnosis contribution (Pasotti, 2006).
The Differences between Angina, Silent Ischemia, and Myocardial Ischemia
Angina refers to the condition where the chest experiences some level of discomfort due to poor flow of blood through the blood vessels mostly coronary vessels of the myocardium (heart muscles). Silent ischemia, on the other hand, refers to the condition where blood rich in oxygen does not flow throughout the whole body due to restrictions on a single body part. Myocardial ischemia is also known as cardiac ischemia which refers to the condition where there is a reduction in the amount of blood flowing to the heart thus resulting to a low level of oxygen and oxygenated blood in the heart.
Three Factors Associated With Sudden Cardiac Death (SCD)
SCDs are responsible for 60% plus of deaths resulting due to cardiovascular conditions and a leading death cause of patients across the globe. Myocardial ischemia stands tall among the cause of SCDs. The heart is in control of propelling oxygenated blood to the rest of the body, failing to get enough would definitely result in an SCD (Wang, 2017). Another factor is angina, if the heart muscles fail to get enough blood there will be poor blood pumping which would eventually result in an SCD. Then there is hypertension, which may exert excess pressure to the blood vessels resulting in death. Other factors may include familial aggregation, age, lifestyle, and sex among others.
The Possible Complications Post-MI Might the NP Be Aware of When Caring For John
Before being rushed to the hospital, John experienced a severe chest pain and shortness of breath. The pain is said to be severe than his usual anginal pain and radiated to the jaw and the left arm. Having this in mind, the care providers should consider a number of life-threatening conditions including heart attack. More so, the anginal pain being severe than normal is a sign that there is more need for oxygen in the heart which may indicate that Myocardial ischemia is taking over.
References
MacGill, M. (2017, December 11). Everything you need to know about hypertension. Medical News Today . Retrieved from https://www.medicalnewstoday.com/articles/150109.php
Olsen, N. (2017, August 31). NSTEMI: What You Need to Know; Health Line . Retrieved from https://www.healthline.com/health/nstemi
Pasotti, M., Prati, F., & Arbustini, E. (2006). The pathology of myocardial infarction in the pre‐ and post‐interventional era. BMJ Journal . 92(11): 1552–1556. DOI: 10.1136/hrt.2005.086934
Roth, E. (2017, May 26). Stable Angina; Health Line . Retrieved from https://www.healthline.com/health/stable-angina
University of Illinois-Chicago. (2017, February 14). Diltiazem, Oral Capsule; Health Line . Retrieved from https://www.healthline.com/health/diltiazem-oral-capsule
Wang, D., Wang, X., Wu, J., Su, R., Kong, J., & Yu, X. (2017) Metabolic risk factors associated with sudden cardiac death (SCD) during acute myocardial ischemia, Forensic Sciences Research, 2 (3): 126-131. DOI: 10.1080/20961790.2017.1343269
