DISORDERS OF THE HEART
ANGINA
MYOCARDIAL INFARCTION
HEART BLOCK
CONGESTIVE HEART FAILURE
OBSERVATIONS TO REPORT IN PATIENT’S
WITH CARDIAC DISORDERS
 Color changes
 Changes in pulse rate or rhythm
 Changes in BP
 Edema
 Disorientation
 Pt. c/o SOB
 Pt. c/o chest pain/pressure/discomfort
 Diaphoresis
 Pt. c/o N&V
Subjective or Objective????
ANGINA PECTORIS
 “Pain of effort”- when coronary arteries are unable to
carry enough blood to meet the heart’s demand for
oxygen
 Can develop gradually or suddenly
 Increase stress on
heart
ANGINA PECTORIS
 Factors that could bring on an attack:
 Exertion
 Heavy eating
 Emotional stress
ANGINA PECTORIS
S&S:
Pain with exertion/exercise
Pain/pressure/discomfort
Pale/flushed face
Diaphoretic
Treatment:
Drugs
Avoid stress/sudden exertion
MYOCARDIAL INFARCTION (MI)
Heart attack:
An acute MI occurs when the coronary arteries are
blocked. Part of the heart muscle supplied by these
vessels becomes ischemic. Unless circulation is
restored quickly, the cells die (infarction)
MYOCARDIAL INFARCTION
Can be caused by occlusion in coronary artery that
“feeds” the heart.
MYOCARDIAL INFARCTION
S&S:
Pain/discomfort/pressure in chest
Heaviness in arm
Restlessness
N&V
Cyanosis
Irregular pulse/respirations
Diaphoretic
Anxiety/weakness
SOB
Syncope
Hypotension
MYOCARDIAL INFARCTION
Treatment is directed towards:
1. Relieving pain
2. Reducing heart’s activity (work load)
3. Altering clotting ability of blood (drugs)
4. Administering drugs to dissolve clot
What is the difference between an MI and an
angina attack?
HEART BLOCK
Condition that develops due to interference in the
electrical current through the heart. The flow of this
electrical current through the heart muscle makes the
normal cardiac cycle.
Pacemaker- electronic device that is implanted under
the chest muscles that carries electrical current
through the heart muscle to replace the “lost control.”
CONGESTIVE HEART FAILURE (CHF)
Failure of the R side of the heart to pump efficiently,
which results in congestion of the lungs.
At first the heart enlarges (hypertrophy) to
compensate for additional loads. Eventually, it can
no longer maintain flow. Because the weakened heart
moves less blood with each pump, fluid backs up in the
lungs. The heart looses it’s “squeezing power”, and the
heart must work harder to maintain the blood flow.
The body (especially lungs)becomes congested with
fluid, which is why it is called congestive heart failure.
Causes of CHF
 High blood pressure
 Heart attack
 Valve problems
 Obesity
S&S of CHF
 Dyspnea
 Orthopnea- difficulty breathing unless sitting






upright
Edema
Fatigue
Cough
Ascites- fluid in abd.
Confusion associated with hypoxia (not enough O2)
Enlarged heart
S&S of CHF
Treatment of CHF
 Drugs to diuresis (urinate to lose fluid)
 Low sodium diet
 Fluid restriction
 Daily weights
 High fowler’s position
 Assist with ADLs
 Monitor I&O
 TED stockings
Complications of CHF
 Acute Pulmonary Edema- life threatening, acute
episode where lungs fill with fluid
Review Questions
1.
2.
3.
4.
5.
6.
Why do patients who suffer from R sided heart
failure experience pulmonary symptoms?
What is the difference between angina and an MI?
What is the relationship between coronary
arteries, ischemia, and infarction in an MI?
What are symptoms of an MI?
How do we treat heart block?
Why would you see edema in CHF, especially in the
feet?
Review Questions
7. What position is best for pulmonary edema?
9. How is atherosclerosis related to CHF?
10. Is a large heart a better functioning heart? Explain