NUR 6111 cardiovascular-QUESTIONS AND
ANSWERS | 2026 UPDATED | 100% CORRECT
chronic unstable angina
chest pain precipitated by exertion and relieved by rest
unstable angina and chronic stable angina both result from
atherosclerotic lesions in the coronary arteries
silent myocardial ischemia
asymptomatic heart disease
occurs when there is objective evidence of increased myocardial oxygen demand
elderly and DM more at risk
increased risk of progressive ischemia, MI and sudden death
Microvascular angina
chest discomfort without angiographic evidence of coronary artery obstruction
chest pain that occurs more unpredictably, sometimes at rest, with physical activity or with
stressful events
more intense, lasting for longer periods of time and does not dissipate with rest
,more intense in the post exercise recovery period when the imbalance between oxygen and
metabolic demands persist
crescendo Decresendo pattern that may change over time
extreme tiredness
more common in women, post menopause
treatment microvascular angina
treatment aimed to relieve pain
beta blockers prescribed first
what aggravates symptoms of microvascular angina
long acting nitrates
Vasospastic angina
coronary artery spasm can cause chest discomfort at rest with evidence of transient ST segment
elevation or depression on ECG
spontaneous, unprovoked
circadian pattern
hyperventilation may occur prior
smoking is a precipitating RF
,first line treatment vasospastic angina
calcium channel blockers
lifestyle modification
RF for vasospastic angina
smoking, hx of migraines, mental stress, alcohol consumption, central nervous system
stimulants, sympathomimetic agents, beta blockers, parasympathometic agents (acetylcholine),
ergot alkaloids and exposure to the cold
Stable angina
symptoms that occur with predictable frequency, severity, duration and provocation
symptoms occur with exertion and are relieved within minutes by rest or nitroglycerin treatment
remains constant unless an acceleration of the disease process occurs
can progress, improve or remain stable for years
Stable angina symptoms
dyspnea, diaphoresis, nausea, vomiting, eructations, diarrhea, fatigue
atypical symptoms are more common in women, older adults, patients with diabetes
relief with stable angina
1-3 minutes after discontinuation of activity or with rest
, Questions for patients with angina
Precipirating factors (exertion, meals, stress, cold)
Quality (pressure, squeezing, burning, stabbing)
Radiation (shoulders, arm, wrist, neck, jaw, back)
Relief measures (rest, nitroglycerin, food)
Severity
Timing (activity, bedtime, meals, history of occurrence, duration)
Associated factors
Dyspnea
Provoked by activity (chest pain first or dyspnea)
Orthopnea (how many pillows)
Paroxysmal nocturnal dyspnea (how soon after retiring to bed)
Diaphoresis
Gastrointestinal complaints (nausea, vomiting, diarrhea)
Fatigue
Cardiac RF
Current medication profile
Beta blockers and calcium channel blockers
first line therapies for angina
long acting nitrates or ranolazine may be added with long acting nitrates
daily nitrate free interval of a minimum of 8 hours should be provided to avoid tolerance
ANSWERS | 2026 UPDATED | 100% CORRECT
chronic unstable angina
chest pain precipitated by exertion and relieved by rest
unstable angina and chronic stable angina both result from
atherosclerotic lesions in the coronary arteries
silent myocardial ischemia
asymptomatic heart disease
occurs when there is objective evidence of increased myocardial oxygen demand
elderly and DM more at risk
increased risk of progressive ischemia, MI and sudden death
Microvascular angina
chest discomfort without angiographic evidence of coronary artery obstruction
chest pain that occurs more unpredictably, sometimes at rest, with physical activity or with
stressful events
more intense, lasting for longer periods of time and does not dissipate with rest
,more intense in the post exercise recovery period when the imbalance between oxygen and
metabolic demands persist
crescendo Decresendo pattern that may change over time
extreme tiredness
more common in women, post menopause
treatment microvascular angina
treatment aimed to relieve pain
beta blockers prescribed first
what aggravates symptoms of microvascular angina
long acting nitrates
Vasospastic angina
coronary artery spasm can cause chest discomfort at rest with evidence of transient ST segment
elevation or depression on ECG
spontaneous, unprovoked
circadian pattern
hyperventilation may occur prior
smoking is a precipitating RF
,first line treatment vasospastic angina
calcium channel blockers
lifestyle modification
RF for vasospastic angina
smoking, hx of migraines, mental stress, alcohol consumption, central nervous system
stimulants, sympathomimetic agents, beta blockers, parasympathometic agents (acetylcholine),
ergot alkaloids and exposure to the cold
Stable angina
symptoms that occur with predictable frequency, severity, duration and provocation
symptoms occur with exertion and are relieved within minutes by rest or nitroglycerin treatment
remains constant unless an acceleration of the disease process occurs
can progress, improve or remain stable for years
Stable angina symptoms
dyspnea, diaphoresis, nausea, vomiting, eructations, diarrhea, fatigue
atypical symptoms are more common in women, older adults, patients with diabetes
relief with stable angina
1-3 minutes after discontinuation of activity or with rest
, Questions for patients with angina
Precipirating factors (exertion, meals, stress, cold)
Quality (pressure, squeezing, burning, stabbing)
Radiation (shoulders, arm, wrist, neck, jaw, back)
Relief measures (rest, nitroglycerin, food)
Severity
Timing (activity, bedtime, meals, history of occurrence, duration)
Associated factors
Dyspnea
Provoked by activity (chest pain first or dyspnea)
Orthopnea (how many pillows)
Paroxysmal nocturnal dyspnea (how soon after retiring to bed)
Diaphoresis
Gastrointestinal complaints (nausea, vomiting, diarrhea)
Fatigue
Cardiac RF
Current medication profile
Beta blockers and calcium channel blockers
first line therapies for angina
long acting nitrates or ranolazine may be added with long acting nitrates
daily nitrate free interval of a minimum of 8 hours should be provided to avoid tolerance
