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Chapter 2
•
Cardiovascular Care
CORONARY ARTERY
DISEASE OR ISCHEMIC
HEART DISEASE
Ischemic heart disease (IHD) is often
termed CAD, which is generally
caused by a diminished blood flow
CORONARY VASCULAR DISORDERS
PICTURING
PATHO
Illustration of Assessment Areas of Chest Pain Based on Point of Origin
Right
atrium
Right
atrium
Left atrium
Circumflex branch
of left coronary
artery
Left circumflex
branch
Coronary sinus
Left pulmonary veins
Anterior
descending
branch of
left coronary
artery
Right
coronary
artery
Right
ventricle
Left ventricle
A
B
Superior
vena
cava
Superior
vena cava
Aortic arch
Right
ventricle
Posterior descending
branch of right
coronary artery
Inferior
vena
cava
Right pulmonary veins
Aortic valve
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
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.
Musculoskeletal Disorders (costochondritis
Pulmonary Disorders (pneumonia, pulmonary
embolism)
Right side
Back
Usual distribution
of pain with
myocardial
ischemia
Less common sites of pain with myocardial ischemia
Angina Pectoris, ACS (unstable angina, MI)
Jaw
Epigastrium
Esophageal Disorders (hiatal hernia, reflux
esophagitis or spasm)
Pericarditis
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.