Modifiable risk factors for coronary artery disease (CAD) for F.M. are smoking, sedentary lifestyle, and slightly elevated BMI (29.3 kg/m2). Non-modifiable risk factors include family history of heart disease and age (68 years).
The pain associated with chronic stable angina is typically relieved with rest or nitroglycerin, whereas pain associated with myocardial infarction (MI) is not relieved with rest or nitroglycerin.
Diagnostic studies indicated for F.M. include cardiac markers, such as troponin levels, and a cardiac catheterization to assess for blockages in the coronary arteries.
The priority nursing care for F.M. includes assessing and managing pain, monitoring vital signs, administering medications as ordered (such as nitroglycerin and morphine), and preparing the patient for cardiac catheterization or other diagnostic tests.
Other interventions anticipated for F.M. at this time include initiating lifestyle modifications to decrease modifiable risk factors, such as smoking cessation and increasing physical activity, and providing education on medication management and symptom recognition. The healthcare team may also discuss the possibility of cardiac rehabilitation and additional cardiac interventions, such as angioplasty or coronary artery bypass grafting, depending on the results of diagnostic testing.