Page 1697 - Saunders Comprehensive Review For NCLEX-RN

E. Surgical procedures

1. PTCA to compress the plaque against the walls of the
artery and dilate the vessel
2. Laser angioplasty to vaporize the plaque
3. Atherectomy to remove the plaque from the artery
4. Vascular stent to prevent the artery from closing and
to prevent restenosis
5. Coronary artery bypass grafting past the occluded
artery to improve blood flow to the myocardial tissue
at risk for ischemia or infarction
F. Medications
1. Nitrates to dilate the coronary arteries and decrease
preload and afterload
2. Calcium channel blockers to dilate coronary arteries
and reduce vasospasm
3. Cholesterol-lowering medications to reduce the
development of atherosclerotic plaques
4. Beta blockers to reduce the BP in individuals who are
hypertensive
VIII. Angina
A. Description
1. Angina is chest pain resulting from myocardial
ischemia caused by inadequate myocardial blood and
oxygen supply.
2. Angina is caused by an imbalance between oxygen
supply and demand.
3. Causes include obstruction of coronary blood flow
resulting from atherosclerosis, coronary artery spasm,
or conditions increasing myocardial oxygen
consumption.

The goal of treatment for angina is to provide relief from the

acute attack, correct the imbalance between myocardial oxygen supply
and demand, and prevent the progression of the disease and further
attacks to reduce the risk of MI.
B. Patterns of angina
1. Stable angina
a. Also called exertional angina
b. Occurs with activities that involve
exertion or emotional stress; relieved
with rest or nitroglycerin
c. Usually has a stable pattern of onset,
duration, severity, and relieving
factors
2. Unstable angina
a. Also called preinfarction angina

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