Unstable Angina

Unstable Angina

New in onset

Occurs at rest

Has a worsening pattern.

Myocardial Infarction Severe

• Persistent chest pain not relieved by rest or nitrate administration may mean the patient is having an MI

Unstable Angina

■ It may occur while the patient is active or at rest, asleep, or awake.

• Pain often occurs in the early morning hours.

• It usually lasts for 20 min or longer.

Unstable Angina Pain (S/SX)

■ Unlike any other pain, it is usually described as a heavy, pressure, tight, burning, constricted, or crushing feeling.

• Common locations are the substernal or epigastric area.

  • The pain may radiate to the neck, lower jaw, and arms or to the back.

• When epigastric pain is present, the patient may relate it to indigestion, take antacids without relief, and therefore delay seeking treatment.

Unstable Angina

■ Some patients may not have pain but may have “discomfort,” weakness, nausea, indigestion, or shortness of breath.

• Some women may have atypical discomfort, shortness of breath, or fatigue.

■ Patients with diabetes may have silent (asymptomatic) MIs because of cardiac neuropathy or have atypical symptoms (e.g., shortness of breath).

■ An older patient may have a change in mental status (e.g., con-fusion), shortness of breath, pulmonary edema, dizziness, or a dysrhythmia.

• The patient’s skin may be ashen, clammy, and cool (cold sweat). The patient may have nausea and vomiting. Fever occurs within the first 24 hr (up to 100.4°F [38°C])