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Angina III: Clinical Manifestations and Assessment01:29

Angina III: Clinical Manifestations and Assessment

Angina manifests as chest pain, tightness, or squeezing discomfort typically located behind the breastbone. It can radiate to the neck, jaw, shoulders, and inner aspects of the upper arms, most commonly the left arm. Patients may experience shortness of breath, fatigue, profuse sweating, dizziness, indigestion, heartburn, palpitations, anxiety, and vomiting as accompanying symptoms. This pain often lasts a few minutes and is triggered by physical exertion, emotional stress, heavy meals, or cold...
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Angina, a symptom of myocardial ischemia, requires a structured nursing management approach to ensure effective care and prevent complications like myocardial infarction. Comprehensive nursing care involves assessing, diagnosing, planning, implementing interventions, and evaluating outcomes, all tailored to the individual patient's needs.Patient AssessmentNursing assessment begins with a detailed subjective evaluation of symptoms, which typically include chest pain or pressure radiating to the...
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Sexual function in patients with chronic angina pectoris.

Robert A Kloner1, Luana Henderson

  • 1Department of Medicine, Division of Cardiovascular Medicine of Keck School of Medicine and Good Samaritan Hospital, University of Southern California, Los Angeles, CA, USA. rkloner@goodsam.org

The American Journal of Cardiology
|April 6, 2013
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Summary

Erectile dysfunction (ED) drugs are often contraindicated with nitrates for angina. Patients with coronary artery disease and ED need careful evaluation before ED treatment to ensure cardiovascular safety.

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Area of Science:

  • Cardiology
  • Urology
  • Pharmacology

Background:

  • Erectile dysfunction (ED) and angina pectoris frequently coexist in patients with coronary artery disease (CAD).
  • Nitrates, a common angina treatment, are contraindicated with phosphodiesterase-5 inhibitors (PDE5i) used for ED.
  • Existing antianginal therapies may pose risks to cardiovascular health or erectile function.

Purpose of the Study:

  • To review the contraindications and interactions between antianginal therapies and ED medications.
  • To emphasize the importance of cardiovascular risk assessment for patients with CAD and ED considering ED treatment.
  • To discuss alternative antianginal strategies for patients requiring PDE5i therapy.

Main Methods:

  • Literature review of current antianginal therapies and their effects on erectile function.
  • Analysis of guidelines from the American Heart Association and Princeton Consensus Conference.
  • Discussion of pharmacological interactions between nitrates, PDE5 inhibitors, and other antianginal agents.

Main Results:

  • Short- and long-acting nitrates are absolute contraindications for concurrent use with PDE5 inhibitors.
  • Other antianginal therapies (e.g., beta-blockers, calcium channel blockers, ranolazine) require careful consideration of cardiovascular and erectile function effects.
  • Medical evaluation is crucial to assess risks associated with sexual activity in CAD patients with ED.

Conclusions:

  • Patients with CAD and ED needing PDE5i therapy must discontinue nitrates safely.
  • Effective angina management, cardiovascular health maintenance, and preserved sexual function are key goals.
  • Individualized treatment plans are essential for managing coexisting angina and ED.