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Atlanta Legal Nurse Consultant Updates In Cardiology Regarding Angina In Patients With Heart Disease


Atlanta, Georgia – Atlanta legal nurse consultant Liz Buddenhagen attended “Epideminology, Pathophysiology and Therapeutic Targets in Stable Ischemic Heart Disease” in Athens, Georgia on April 4, 2013.

Mark A. Zenker, MD, FACC of Saint Thomas Heart in Nashville, Tennessee, discussed the incidence of angina based on the Framingham Heart Study, chronic stable angina, the magnitude and impact of ischemic heart disease in women and the persistence of angina despite the use of heart procedures and traditional drug therapy in some patients.

Zenker pointed out that appropriate, current medical treatment yields the same or similar results as common procedures such as angioplasty with stenting and bypass graft surgery. Approximately one-third of patients who have undergone these procedures are experiencing angina within one year of having the procedures done, he said.

“Women typically have angina before having a heart attack whereas men present with angina while having a heart attack,” he said. 

Angina presents as a sensation of chest discomfort over or near the sternum usually described as heaviness, pressure, squeezing, smothering or choking and rarely as frank pain, according to Zenker. Precipitating factors include exercise, cold environment, walking after a meal, emotional upset, fright, anger and coitus.

Furthermore, he noted, angina pectoris may be atypical in location and not strictly related to provoking factors especially in women and diabetic patients. Symptoms of myocardial (heart muscle) ischemia (oxygen deprivation) other than angina can include dyspnea, nausea, fatigue and faintness. These are seen more commonly in the elderly and diabetic patients.

Regarding the chronic stable angina, Zenker discussed nitroglycerin tolerance that many patients develop and a newer medication, Ranolazine (Ranexa) that is currently being used with good results for angina in patients who have not had relief in the past. This newer medication affects the sodium and calcium exchanger at the cellular level.
Atlanta legal nurse consultant:

Liz Buddenhagen, registered nurse and certified legal nurse consultant has clinical experience in:

  • cardiac telemetry
  • coronary intensive care
  • cardiovascular intensive care 
  • cardiac telemetry
  • adult critical care 
  • neonatal intensive care
  • medical-surgical nursing.

Buddenhagen currently assists Atlanta attorneys with medical issues of their legal cases. For more information, please view, email or call 770-725-2997 today.


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