CORONARY HEART DISEASE & NURSING

Coronary Heart Disease & Nursing

Coronary Heart Disease & Nursing

INTRODUCTION

Coronary Heart Disease accounts for approximately 5% of all medical admissions to hospital (National Service Framework, Department of Health 2000). Its prevalence is expected to continue to rise over the next several decades due to decreased mortality from cardiovascular disease and the growth of the elderly population. The National Service Framework for Coronary Heart Disease (CHD) in Wales (The National Assembly for Wales 2001) sets aims to health authorities, local health groups and the Specialist Health Services Commission for Wales in tackling CHD within Wales. The key actions for heart failure patient care is to provide a comprehensive and cost effective heart failure service for all, and to implement an agreed pathway for the care of those with chronic heart failure. An agreement reached with 1-2 tertiary centres to assess resistant/end stage heart failure patients within an agreed protocol and the development of a strategy for the palliative management of symptomatic endstage heart failure.

During the era of uncertainty in health care, cost-conscious tactics are being implemented widely among primary and secondary health care sectors. Coronary Heart Disease (CHD) has been the focus of numerous recommendations, 78% of patients with CHD have at least two admissions per year for CHD exacerbation and 16% have had three admissions per year (McMurray et al 1993). It has been speculated that many of the 1 million CHD hospitalisations that occur each year could be prevented by improved evaluation and care.

SYMPTOMS OF CHD

Heart attacks can cause permanent damage to the heart muscle, and if not treated straight away, can be fatal. If you think that you are having a heart attack, you should dial 999 for immediate medical assistance.

If you have coronary heart disease, you may experience heart palpitations. Heart palpitations occur when your heart beats irregularly, or harder than normal. It is important to realise that heart palpitations are not necessarily linked to coronary heart disease, and if you experience them, you should not worry unduly. However, it is always best to have it checked out by your GP.

Heart failure can occur in people with coronary heart disease. The heart becomes too weak to pump blood around the body, which can cause fluid to build up in the lungs, making it increasingly difficult to breath. Heart failure can happen suddenly (acute heart failure) or gradually, over a period of time (chronic heart failure).

Angina is a symptom of coronary heart disease. It can be a mild, uncomfortable feeling that is similar to indigestion. However, a severe angina attack can cause a feeling of heaviness or tightness, usually in the centre of the chest, which may spread to the arms, neck, jaw, back or stomach.

Angina is often triggered by physical activity or emotionally stressful situations. The symptoms usually pass within about 10-15 minutes and can be relieved by resting, or using a nitrate tablet or spray.

The discomfort or pain of a heart attack is similar to that of angina, but it is often more ...