متاح الآن! بحث تيليغرام 2025 — أهم رؤى العام 
Team Faculty Of Nursing internship 💙
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اللهم اجعل عملنا كله صالحاً ، واجعله لوجهك خالصاً ، ولا تجعل لأحد من خلقك فيه شيئاً، ولا للشيطان منه نصيباً، وتقبله يا ربنا بقبولٍ حسن. 'إنَّ الله لا يُضيع أجر من احسنَ عملا ' وقل اعملو فسيرى الله عَمَلكم ورسُولُه والمؤمنون
إظهار المزيد9 374
المشتركون
-424 ساعات
-207 أيام
+3730 أيام
أرشيف المشاركات
⛔⚠️ المهم ف محاضره Angina :
🔛 Acute coronary syndrome includes un stable angina and acute myocardial infarction.
⬅️Cause of angina is myocardial ischemia
⬅️ Cause of ischemia is blockage or spasm in coronary artery.
◀️ Classification of angina :
1- Stable Angina
2- unstable angina
3- variant angina
➡️➡️➡️➡️➡️➡️➡️➡️➡️➡️➡️
➡️ Stable Angina :
*usually predictable
*pain lasts from 3to 5 minutes.
*pain relieved by rest or sublingual nitroglycerin.
◀️ ECG reveals ST segment depression.
➡️➡️➡️➡️➡️➡️➡️➡️➡️➡️
◀️ Unstable Angina :
# known as pre infarction angina
# pain more intense and occur at rest.
# pain lasts more than 15 minutes.
# pain not relieved by nitroglycerin.
# pain report epigastric pain.
◀️ It’s signal of atherosclerotic plaque rupture and thrombus formation.
◀️ Requires immediate treatment as patient risk for MI cardia dysrhythmia or cardiac death.
⬅️⬅️⬅️⬅️⬅️⬅️⬅️⬅️⬅️⬅️⬅️⬅️
◀️ Variant Angina known as prinzmental's or vasospastic Angina.
# it form of unstable angina occur result of intense coronary spasm.
# occur at rest and cyclic occurring at the same time every day between midnight & 8 am.
# pain lasts 5 to 30 minutes.
◀️ ST segment elevation and chest pain.
◀️ It respond to nitrates and calcium channel blockers.
◀️ Spasm occur near the area of blockage.
⬅️ECG Standard diagnostic test for patients with angina.
⬅️ Place patient in bed rest to decrease O2 demands.
➡️ بنعمل Assessment ل pain ب NOPQRST.
بعد ال Assessment بنعمل Diagnoses وبعدين Relieving chest pain عن طريق :👇
1- Oxygen
2-Nitrates
3- Analgesia
4-Aspirin
◀️ كنا بنعطيله Nitrates عشان :
1-Improve arterial flow to ischemic area.
2- dilate coronary artery
3- reduce chest pain
4- reduce O2 demand.
خدوا بالكم من دي :👇
↪️ Side effects of Nitroglycerin :
Hypotension
Headache
Flushing
Dizziness
➡️ لما بعطيله Morphine آخد بالي من Respiratory rate and blood pressure
↪️ Side effects of Morphine :
Hypotension
Respiratory depression
decrease urine output.
🔚بالنسبه ل Diet :
Take low fat low salt diet.
Take high fibers
include Omega 3 fatty acid in diet.
Reduce intake of Caffeine.
بس كدا 😂🌚💜
⚠️⛔ المهم ف MI :👇
🔛 MI is described irreversible myocardial necrosis (cell death) caused by prolonged ischemia due imbalance between Oxygen demond and oxygen supply.
◀️ Size of infarction depend on severity, duration of ischemia, size of the vessel, vascular tone and metabolic demond.
◀️ If Area of infarction small the necrotic wall difficulty in moving.
◀️ If the damage to myocardial more extensive, myocardial tissue without motion.
◀️The large of infarction the greater the effect on ventricular circulation
⬅️ Zone of infarction : the area of cellular death and necrosis ( Q waves)
⬅️ Zone of injury : the area surronds infrarcted zone (ST segment elevation)
⬅️Zone of ischemia :the outer region of myocardium ( T wave inversion)
بصوا علي شكل الموجات هتلاقوا صوره مبعوته ليها.
⬅️لما الحاله بتدخل بنعمل ليها ECG لو طلع ف الرسم ST elevation دا بيكون MI لو طلع No ST elevation بنعمل Cardiac markers لو طلعت النتيجه سلبيه بتكون دي Un stable Angina لو طلعت ايجابيه بتكون MI بس من النوع Non ST elevation.
STEMI ↪️ non Q wave Mi
NSTMI ↪️ Q wave Mi
⬅️ عندنا نوعين من MI :
↪️ Non ST segment elevation ( unstable angina /NSTEMI) is partial obstruction of coronary artery resulting in partial thickness of myocardium.
↪️ ST segment elevation ( STEMI) : complete obstruction of coronary artery resulting in damage full thickness of myocardium.
اعراضه :
◀️Curshing substernal chest pain
◀️ Pain like an elephant sitting on the chest.
◀️ Pain prolonged and not relieved by rest or Nitroglycerine.
◀️ Pain respond to morphine.
◀️ Pain associated with nausea, vomiting, diaphrosis
◀️ Cool clammy skin
◀️ Fever
◀️ Feeling of impending doom بيحس ان روحه بتطلع
⬅️Hypertension and tachycardia due to sympathetic tone
⬅️ Hypotension and bradycardia due to vagal tone
من ضمن physical examination :
Increase Central venous pressure
Abnormal breathing sounds
Peripheral edema
⏹️ من ضمن Diagnostic procedures :
ECG
Chest x ray
Serum cardiac markers↪️عباره عن انزيمات موجوده ف عضله القلب اول مابيحصل تعب او تدمير ف عضله القلب الانزيمات دي بتخرج ف الدم وبتتحدد بالتحليل.
⬅️ Troponins not present in blood of healthy person.
⬅️Troponins are not helpful in early detection of MI. (less than 6 hours)
↪️ Troponins T elevated for 5 to 14 days
↪️ Troponins I elevated for 5 to 10 days.
⬅️ Creatine kinase (CK) : it useful in early diagnosis of early infarction.
⬅️Cratine kinase : less sensitive and less specific than Troponins for detecting myocardial damage.
⬅️ Myoglobin : it release from ischemia muscle earlier than the release CK.
⏹️ it useful in early diagnosis of early infarction.
الادويه :
⏹️ Fibrinolytic therapy. مذبيات الجلطه it’s provide maximal benefit if given the first 3 hours after onset of symptoms.
⏹️ Intravenous Nitroglycerine
⏹️ Morphine sulfate.
⏹️ Beta blocker Intravenous which reduce myocardial contractility and reduce the workload of heart and decrease oxygen demond.
↪️ The patient must be observed for bradycardia and hypotension
⏹️ Calcium channel blocker :بنعطيه ف حاله ان المريض مش استجاب ل Nitrates and Beta blocker
⏹️ Combination of aspirin (chewing) an anti coagulant and anti platelet drug recommended
🔚 Aspirin should be administration as soon as the diagnosis of unstable angina and NSTEMI is suspected unless contraindicated.
وبس كدا 🙂 انا لسه مخلصتش والله بس عملته عشان اتطلب مني 😊❤️
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