Anterior Ischemia:what does it mean?

Specialties Cardiac

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Specializes in Med/Surg, LTACH, LTC, Home Health.

Hi guys!

I was wondering if anyone had any info on this condition. I'm not a cardiac nurse, but I am interested in learning more since my dad shocked us all with needing open-heart back in January. Thankfully, he's wonderful now.

I was floated to our hospital's chest pain unit and now that we have to do our own EKGs, I'm more curious than ever. The only thing I know about this is that it involves the front portion of the heart. What usually follows this? Can we expect this patient to undergo a heart cath next, symptomatic or not? Our EKG or rhythm strip interpretation learning exercises are all online and self-taught at the job? So, I thought I would come here and ask the experts. ;)

Thanks for your time!

Specializes in RETIRED Cath Lab/Cardiology/Radiology.

Not ignoring your questions, BSNINTHEWORKS!!, just formulating a response because "anterior ischemia" is the tip of a HUGE iceberg. :)

Will be back with more, hopefully later today.

Specializes in Med/Surg, LTACH, LTC, Home Health.

Thank you! I look forward to it!!

Specializes in RETIRED Cath Lab/Cardiology/Radiology.

Found a pretty good and brief explanation here (slightly edited):

From www.doctorslounge.com/cardiology/forums/backup/topic-48928.html

"An electrocardiogram traces the electrical activity(depolarization) of the heart beat. The most basic description isdesignated as P, QRS and T waves.

Very briefly, the P wave is a normal beat in which the electrical depolarization spreads from the right atrium to the left atrium, resulting in the beat of the upper chambers of the heart.

The QRS portion is the rapid depolarization of the right and left ventricles, resulting in the beat of the lower chambers of the heart; since the ventricles are larger than the atria, that portion appears larger on the electrocardiogram.

The T wave represents the repolarization (or recovery) of the ventricles.

Ischemia occurs when blood flow is decreased through one or more of the arteries in the heart muscle; in this case, to the anterior portion of the heart. The main risk factors that can lead to ischemia are elevated cholesterollevels, elevated blood pressure, and diabetes. Ischemia can be the result of coronary artery disease(atherosclerosis), in which plaques formed of cholesterol and possibly other cellular waste products build up on an artery wall and restrict the blood flow. This is the most common cause of myocardial (heart muscle) ischemia. Some other conditions include blood clots, causing a sudden ischemic event which may lead to heart attack; coronary artery spasm, which is brief and temporary; and severe illnesses, such as those leading to blood loss.

Medications used in the treatment of ischemia include

aspirin,which reduces the tendency of blood to clot, and nitroglycerin, which temporarily relaxes/opens arteries; and

betablockers, which relax the heart muscle, slow the heart beat and decrease blood flow, with the result that blood flows more easily.

Cholesterol medications include statins,which interfere with the synthesis of cholesterol in the body; niacin, which boosts "good" cholesterol;

fibrates, which are usually used as an adjunct to othercholesterol medications; and

bile acid sequestrants, which help block fats.

Calcium channel blockers, which relax and widen blood vessels by acting on the muscle cells in the arterial walls, which slows the pulse and reduces the heart's workload.

ACE (angiotensin-converting enzyme) inhibitors, which inhibit arterial constriction and help relax the blood vessels and lower blood pressure, and Ranlozine, which helps relax the coronary arteries and is used when other medications aren't effective.

The cholersterol lowering medications target lowering LDL (lowdensity lipoprotein) or "bad" cholesterol and boosting HDL (high density lipoprotein) or "good"cholesterol.

Recommended lifestyle changes are to stop smoking if one is a smoker, exercise, enjoy a healthy diet, and be regularly monitored by a physician."

Specializes in RETIRED Cath Lab/Cardiology/Radiology.

Following are ACC/AHA guidelines for treatment of chest pain:

ACC/AHA Guidelines for the Management of Patients With Unstable Angina and Nonâ€"ST-Segment Elevation Myocardial Infarction: Executive Summary and Recommendations

Specializes in Med/Surg, LTACH, LTC, Home Health.

Thank you very much, dianah, for this information!!! It will help me in my patient teaching efforts as well as my own as I become more efficient in this area of nursing.

BSNINTHEWORKS

Specializes in critical care: cardiac cath lab/ER/ICU.

The ACC guidelines are perfect for NSTEMIs and unstable angina. Typically if trop is negative, no active chest pain, no EKG changes patient would undergo a stress test (most likely nuclear) - if this was positive, next step cath lab. However if chest pain persistent or EKG changes or positive trop - straight to cath lab (at least that is how we do it at my facility). STEMIs of course go straight to cath lab.

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