Angina is chest pain which results from inadequate oxygen flow to the myocardium. If the demand for myocardial oxygen surpasses the ability of the coronary arteries to provide the heart with oxygen, myocardial ischemia happens. Angina is the clinical manifestation of reversible myocardial ischemia caused by either an increased demand for oxygen or a decreased supply of oxygen that can lead to myocardial ischemia (Lewis et al., 2010). Angina is classified as either Chronic Stable Angina (CSA), Unstable Angina (UA) or Prinzmetal's angina. CSA, described as chest pain transpiring periodically over a period of time with an identical pattern of onset, duration, and intensity of symptoms. CSA can further be classified as silent ischemia, nocturnal angina, or angina decubitus (Lewis et al., 2010). Libby et al., refer to Silent ischemia as “ischemia that occurs in the absence of any subjective symptoms” (as cited in Lewis et al., 2010). Nocturnal angina happens at night only; however, not necessarily only when the person is lying down or during sleep. Angina decubitus refers to chest pain that a person experiences solely while lying down. A majority of the time, angina decubitus is relieved by standing or sitting. Prinzmetal's angina frequently occurs at rest, usually as a reaction to spasm of a major coronary artery. UA refers to an acute coronary syndrome (ACS) represented by unpredictable chest pain with occurrences that are new in onset, occur at rest, or have a worsening pattern. Unstable angina is easily provoked with minimal to no exertion, while sleep or rest and its frequency increases. UA represents a medical emergency (Lewis et al., 2010).
Angina is chest pain caused by a lack of oxygen to the myocardial tissues; therefore,...
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The Saskatchewan heath care system is made up of several provincial, regional and local organizations, which provide the people their basic right to reasonable health care (“Health Systems,” 2014). Not having enough health care providers seem to be a problem, which Canada as a whole has struggled with (“College of Family,” 2014). The shortages of medical providers have lead to major discrepancies in the level of patient care between major urban centers and rural areas (Howlett, 2013). In the case of Saskatchewan many communities are facing this challenge, not only rural areas but also the capital city of the province (“Saskatchewan ER,” 2013). Stats Canada has showed that the number of physicians is at a historic high, yet Saskatchewan still face shortages (Howlett, 2013).
Coronary heart disease is defined by the hardening of the epicardial coronary arteries. The buildup of plaque in the arteries slowly narrows the coronary artery lumen. In order to better understand the physiology of the disease, it is important to first know the basic anatomy of the human heart. The aorta, located in the superior region of the heart, branches off into two main coronary blood vessels, otherwise known as arteries. The arteries are located on the left and right side of the heart and span its surface. They subsequently branch off into smaller arteries which supply oxygen-rich blood to the entire heart (Texas Heart Institute, 2013). Therefore, the narrowing of these arteries due to plaque buildup significantly impairs blood flow throughout the heart.
The number of doctors that present in the United States of America directly affects the communities that these doctors serve and plays a large role in how the country and its citizens approach health care. The United States experienced a physician surplus in the 1980s, and was affected in several ways after this. However, many experts today have said that there is currently a shortage of physicians in the United States, or, at the very least, that there will be a shortage in the near future. The nation-wide statuses of a physician surplus or shortage have many implications, some of which are quite detrimental to society. However, there are certain remedies that can be implemented in order to attempt to rectify the problems, or alleviate some of their symptoms.
Angina is pain felt in the chest area as a result of lack of inadequate supply to the myocardium (Better Health Channel, 2013) Atherosclerosis or the hardening and narrowing of arteries caused by the build-up of plaques, the insufficient supply of oxygen and its increasing demand are some of the factors that can cause ischemia in the myocardium (Lewis et al., 2012). When there is a total blockage of the coronary arteries for a few minutes, the myocardium cannot receive oxygen and glucose for aerobic metabolism thus anaerobic metabolism occurs (Lewis et al., 2012). The lactic acid builds up and stimulates the nerve fibres in the myocardium resulting to chest pain (Lewis et al., 2012). The cells are repaired and the aerobic metabolism and the contractility of the arteries are restored when there is return of blood flow (Lewis et al., 2012)
It is no secret that the current healthcare reform is a contentious matter that promises to transform the way Americans view an already complex healthcare system. The newly insured population is expected to increase by an estimated 32 million while facing an expected shortage of up to 44,000 primary care physicians within the next 12 years (Doherty, 2010). Amidst these already overwhelming challenges, healthcare systems are becoming increasingly scrutinized to identify ways to improve cost containment and patient access (Curits & Netten, 2007). “Growing awareness of the importance of health promotion and disease prevention, the increased complexity of community-based care, and the need to use scarce human healthcare resources, especially family physicians, far more efficiently and effectively, have resulted in increased emphasis on primary healthcare renewal.” (Bailey, Jones & Way, 2006, p. 381).
Signs and symptoms come along with any disease, some symptoms may be noticeable but sometimes there's just no symptoms at all. The common symptom for Coronary Heart Disease is chest pain and/or discomfort. This happens when the heart is not getting oxygen and blood. How strong the chest pains are varies from patient to patient. The chest pains my feel like the heart is being squeezed. The pain may be felt below the sternum but also in the neck, arms, stomach, and upper back. The chest pain usually occurs when the patient is doing activities or is in motion but it goes away with rest or a medicine called Nitroglycerin. Other symptoms are sho...
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The inflammation of thin membrane of tissues surrounding the heart causes them to start rubbing against each other which may cause chest pain known as pericarditis..
During one of my undergraduate courses, “Community and Population Health”, I completed a paper on my community and access to healthcare. During the research and community outreach performed to meet the goals of the paper, my eyes were opened to the plight of small communities in regards to access to quality healthcare. This plight has become my passion, and has formed the basis for my vision of the Family Nurse Practitioner role.
Spence Laschinger, H. K., Wong, C. A., Grau, A. L., Read, E. A., & Pineau Stam, L. M. (2011). The influence of leadership practices and empowerment on Canadian nurse manager outcomes. Journal of Nursing Management, 20,877-888.
Oxygen is widely used in both chronic and acute cases, in emergency medicine, at hospital or by emergency medical services (Nicholson, 2004 ). Just like any other form of medication oxygen is a drug that if used incorrectly could cause potential harm, even death (Luettel, 2010 ). Oxygen is admitted to the patient with chest pain for two main rationales. The first is by increasing arterial oxygen tension, which in opposing causes a decrease to the acute ischemic injury, and thus over time the entire infarct area (Moradk...
...elly, P., & Crawford, H. (2013). Nursing leadership & management. In Nursing leadership & management(2nd ed., pp. 168-177). Canada: Nelson Education.
These causes will change the heart significantly. The pathophysiology of heart failure is described differently as: (1) an oedematous disorder, by means of which the deviations in renal hemodynamics and excretory ability lead to salt and water holding; (2) a hemodynamic disorder, considered by peripheral vasoconstriction and decreased cardiac output; (3) a neurohormonal disorder, mainly by stimulation of the renin-angiotensin-aldosterone system and adrenergic nervous system; (4) an inflammatory syndrome, related with amplified local and circulation pro-inflammatory cytokines; (5) a myocardial disease, started with an damage to the heart trailed by pathological ventricular transformation. In heart failure, the heart sustains either a sudden or longstanding structural injury. When damage occurs, sequences of firstly compensatory but consequently maladaptive mechanisms follow (Henry & Abraham, ).
Heart is the giver of life and it sustains life. Everyone in this world wants to have a healthy life. All these connotations signify heart is a primary organ around which any living beings life is revolving. Having healthy heart plays an inextricable role in quality and the length of our life. The heart is inconsistently resilient and competent of a persistent workload but liable to disease and failure as the people don’t pay requisite care that the heart deserves. The heart is located in the center of the chest .it is surrounded by the rib cage and protected by the breast bone.the heart’s job is to keep blood continuously circulating throughout the body. The vesssels that supply the body with oxygen rich blood are called arteries. The vessels that return the blood to the heart are called veins. Like any other muscle in the body , the fatigue-proof cardiac muscle for its relentless pumping function, receives nutrition and oxygen supply through arteries called coronary arteries. Three main coronary arteries lie on the surface of the heart. They divide into smaller branches, so that each part of the heart muscle receives oxygen and nutrients. Sometime thease coronary arteries can become narrowed and blocked by deposits of fat and bad cholesterol and other substances collectively known as plaque in the artery walls. Overtime plaque deposits can narrow the vessels so much and the normal blood flow is restricted. In some cases the coronary artery become so narrow that the heart muscle itself is in danger which is manifested as coronary artery disease (CAD). Consequences of CAD is angina, a chest pain due to deprived oxygen rich blood to the myocardium. Symptoms include pressure, tightness, squeezing, aching, burning, or cramping in ...