Lipp Vis Nursing ChaptLWBK1630_C02_p013-068

30  Chapter 2 • Cardiovascular Care

CORONARY VASCULAR DISORDERS

CORONARY ARTERY DISEASE OR ISCHEMIC HEART DISEASE Ischemic heart disease (IHD) is often termed CAD, which is generally caused by a diminished blood flow

to the myocardium and is the most common manifestation of CAD. The term angina pectoris includes a group of symptoms attributable to myocardial ischemia. Angina pectoris which means “chest pain” is characterized by acute recurrent

attacks of substernal or precordial chest discomfort. Angina is generally caused by a diminished blood flow to the myocardium and is the most common manifestation of CAD. Angina can also occur in other cardiac problems, such

Illustration of Assessment Areas of Chest Pain Based on Point of Origin

Aortic valve

Right pulmonary veins

Superior vena cava

Aortic arch

Left pulmonary veins

Coronary sinus

Superior vena cava

Right atrium

Left atrium

PICTURING PATHO

Circumflex branch of left coronary artery

Right atrium

The coronary arteries supply the heart muscle with oxygenated blood, adjusting the flow according to metabolic needs. A. Anterior view of the heart. B. Posterior view of the heart.

Inferior vena cava

Left circumflex branch Anterior descending branch of left coronary artery

Right coronary artery

Right ventricle

Right ventricle

Posterior descending branch of right coronary artery

Left ventricle

A

B

Usual distribution of pain with myocardial ischemia

Jaw

Epigastrium

Right side

Back

Less common sites of pain with myocardial ischemia Angina Pectoris, ACS (unstable angina, MI)

Pulmonary Disorders (pneumonia, pulmonary embolism)

Pericarditis

Esophageal Disorders (hiatal hernia, reflux esophagitis or spasm)

Musculoskeletal Disorders (costochondritis

Anxiety and Panic Disorders

Reprinted with permission from Hinkle JL, Cheever KH. Brunner & Suddarth’s Textbook of Medical-Surgical Nursing . 13th ed. Philadelphia: Wolters Kluwer; 2013.