Abstract This paper relates that evaluation of chest pain is possibly one of the most important elements of nursing assessment skills. The paper then provides an assessment of myocardial infarction versus angina and shows how discerning angina from a myocardial infarction is a difficult task, requiring the rapid use of evaluation skills as well as the prompt administration of treatment.
Outline:
Introduction
Clinical Paper
Conclusions
From the Paper "Chest pain is notoriously difficult to assess. Depending on the signs and symptoms, findings on the ECG and lab results the management of the patient differs significantly. The classic presenting symptoms of a myocardial infarction (MI) is chest pain or discomfort. Angina pectoris may present the same way but will generally be of shorter duration. Both may be described as pain, pressure, tightness, heaviness, burning or squeezing. Both may radiate into arms, shoulders, jaw or back. Not all patients will have these classic symptoms."
Abstract When a patient presents to emergency with severe chest pain the possibility that the pain is induced by an acute coronary event is very high. In fact acute coronary syndrome includes a wide variety of possible conditions which range from stable angina to myocardial infarction. The case study involves a patient who was in grave danger of a heart attack because of unstable angina which resulted in a degree of heart muscle damage. Contributing factors and subsequent modification of those factors are discussed. This paper also discusses how differential diagnosis is made and how preventive measures are determined and evaluated during the diagnostic procedure.
From the Paper "Coronary Artery Disease is the most prevalent heart-related disease and responsible for more deaths than any other condition. The real tragedy of the disease is that it is caused by avoidable factors of lifestyle and can be prevented through education and self-discipline."
Abstract This paper explores the biology of coronary heart disease and explains that it has been proven that a correct diet and exercise can help prevent this phenomenon. Provides details of the medical process which causes heart disease.
From the Paper "Two of the most common and prevalent cases of coronary heart diseases are coronary artery disease or angina pectoris and heart attacks. In angina pectoris, the hardening and the blocking of arteries happens because of fatty deposits within the walls of the arteries (Weston 1993 170). The organs and parts of the circulatory system concerned with this disease are the arteries and the heart. Coronary heart disease is characterized by the occurrence of angina pectoris, wherein the heart is not able to get sufficient oxygen supply from the blood."
Abstract As the number one cause of death for Americans, cardiovascular disease kills nearly 10% of women between the ages of 45 and 64 and almost 10,000 women under the age of 45 each year. However, despite these high mortality statistics, women are significantly less likely than men to be diagnosed with a myocardial infarction (MI) and are also less likely to receive aggressive treatment. Why does this disparity exist among diagnoses between men and women? Research has shown that significant differences exist in the type and nature of symptoms displayed by men and women, and symptoms of CHD in women may be missed or misattributed. This review explores gender differences in coronary heart disease. It questions what these gender differences are and how recognition of these differences impacts the diagnosis and treatment of CHD in women.
From the Paper "Since the prognosis of women who experience CHD is unfavourable, it is essential that the diagnosis of symptoms is accurate and prompt. Arslanian-Engoren (2000) examined whether emergency department (ED) nurses make different decisions in regards to triage for men and women presenting symptoms of myocardial infarction (MI). This researcher recognized that if nurses were better able to identify symptoms presented by women with CHD, they would be better able to identify the presence of an acute cardiac event, and could therefore quickly initiate aggressive treatments that could save lives."
Tags: myocardial, infarction, unstable, angina, UA
Abstract This paper examines the standards set by the National Service Framework for coronary heart disease regarding emergency cardiac care for patients presenting to the accident and emergency system at a hospital. The paper explains that these standards place a priority on aggressive management and providing early thrombolysis and that this type of treatment is controversial because it is questionable whether, given the suggested timeline and the need to differentiate from non-cardiac causes of chest pain, an adequate history and physical can be performed to prevent the administration of thrombolytics in patients where they are contraindicated. To further examine this topic, the paper gives a clear definition of acute myocardial infarction, looks at how to diagnose a patient with acute chest pain, explores the history, indications, and contraindications of thrombolysis, and reviews a multidisciplinary approach to thrombolytic administration.
From the Paper "The definitive diagnosis of AMI is best obtained by following a standard chest pain protocol. Most accident and emergency wards have these in place. It is standard to initially obtain a 12 lead electrocardiogram (ECG) and begin cardiac monitoring. Patient's routine laboratory studies include electrolytes, blood urea nitrogen (BUN), complete blood count (CBC) and markers for myocardial injury (Creatinine Kinase isoenzyme-myocardial (CK-MB) or troponin). Normal serial CK values rule out an acute infarction but are negative in the setting of acute unstable angina. A slight rise in CK-MB or troponin indicates myocardial injury but is not specific for ischemic syndromes. Troponin assay is highly sensitive for identifying acute coronary syndromes. Troponin has longer half life in the system than CK-MB but is less specific for the identification of infarction as opposed to repeated episodes of myocardial ischemia. As the total CK greater than two times the upper ranges of normal is indicative of infarction it can be used as an adjunct in diagnosis ischemia versus infarction and also in determining the relative efficacy of reperfusion. Serum troponin may take up to six hours to become diagnostically sensitive enough (Dougan, 2001)."
Abstract This paper describes the history, origin and medical uses of the Yohimbe herb. The paper explains that it is popularly used in West Africa as an aphrodisiac. Furthermore, the paper describes the characteristics of the Yohimbe tree and discusses the contraindications for usage of the Yohimbe Herb.
From the Paper "Yohimbe Bark Yohimbe is an herb obtained from the inner bark of the Yohimbe tree that grows wild in various countries in Africa. In West Africa Yohimbe has been and continues to be widely used as a medical plant. The inner bark is used as the herb and is available in tablet liquid extract and powder forms. Traditionally, both the crude bark and purified compound have been used as an aphrodisiac and smoked as a hallucinogen. The bark has also been used in traditional..."
Abstract Peripheral vascular disease is an umbrella term that refers to a range of abnormal conditions that affect veins outside the heart and which usually cause blockages in arteries. This paper examines how, depending on what region of the body is being affected by the peripheral vascular disease, nursing interventions should seek to minimize the impact of the disease process while introducing as much physical rehabilitation into the treatment regimen as medically feasible to delay or prevent further deterioration.
Outline:
Introduction: Definition and Pathology
Epidemiology
Assessment Strategies
Effects of Disorder on Dimensions of Health
Conclusion
From the Paper "The diagnosis of peripheral vascular disease can be performed faster, safer, more affordably, and in a minimally invasive way, according to studies performed at New York University Medical Center, New York City, have determined (Health beat, 2001). The results of these studies showed that when peripheral magnetic resonance angiography scanners are used for this purpose, a combination of ultra-fast, high-resolution imaging sequences with a panoramic table and special peripheral coil are used to allow coverage from the renal arteries to blood vessels in the foot in a single scan (Health beat, 2001). Although peripheral vascular disease may not manifest any symptoms at all, if the disease becomes very severe, more serious problems can develop. "
