Explain to patient :

1. Rest when pain begins to decrease oxygen demands.

2. Take nitroglycerin when any pain begins-it helps dilate coronary arteries and get
more oxygen to heart muscle.
3. Avoid stress and activities that bring on an angina attack.
4. Call 911 if the pain continues for more than 10 minutes or as the patient is taking
the third nitroglycerine dose (1 sublingual dose every 5 minutes, if BP allows, for
maximun of 3 doses).
5. Stop smoking! Smoking is associated with heart disease
6. Adhere to the prescribed diet and exercise plan. Lower cholesterol and fat intake
to decrease further plaque build-up, and descease excess salt intake to help BP
control. Slowly increase exercise to build up activity tolerance. Possibly exercise
with cardiac rehabilitation.
7. How to recognice the symptoms of a myocardial infarction: Pay attention to chest
pains as well as changes in patterns o pain and respons to treatment. Be aware o
changes in respiratory patterns, increase in shortness of breath, swelling, and
general feelings og malaise.

PATHWAY

Aterosklerosis
spasme arteri
coronia, anemia

Peningkatan rangsang
sistem saraf simpatis

Kontriksi vaskular,
peningkatan frekuensi
nadi, tekanan darah dan
kontraktilitas

STRES ( fisik atau

psikis)
Merusak sel-sel jantung,
meningkatkan kadar
leukosit
( proses inflamasi
jaringan) dan platelet.

Mengeluarkan
potasium, histamin
dan serotinin

Iskemia dan
hipoksia
Metabolisme sel berubah
dari aerobik menjadi
anaerobik

penumpukan asam
laktat

Merangsang ujungujung saraf

Energi ATP
menurun
Na+>> dalam sel
K+>> di laur sel

nyeri
Saraf sensoris jantung merangsang
saraf sensoris pada bagian badan lain
(pada bidang medio spinalis-torakal).
Nyeri menjalar dan merangsang
sistem saraf otonom
anggina

Kontrakso miokard
terganggu

Meningkatkan
pelepasan
norephineprine/
katekolamin
Aggregasi platelet dan
thromboxane A
meningkat