The patient is being treated for angina. He asks the nurse if angina is the same thing as having a heart attack. What is the best response by the nurse?
1. "They have some things in common, for example, severe emotional distress and panic can accompany both angina and myocardial infarction."
2. "Angina means heart muscle is not getting enough oxygen, while heart attack, or myocardial infarction, means part of your heart has died."
3. "Actually, it depends on what type of angina you mean; there are several types."
4. "They are basically the same."
2
Rationale 1: This is a true statement but is not the best explanation for the patient.
Rationale 2: A myocardial infarction indicates ischemia and necrosis have occurred to the affected part of the myocardium. Angina results from ischemia without necrosis.
Rationale 3: There are several types of angina; however, this response does not answer the patient's question.
Rationale 4: There are differences between angina and myocardial infarction.
Global Rationale: Angina pectoris is acute chest pain caused by insufficient oxygen reaching a portion of the myocardium. Accompanying the discomfort is severe emotional distress, a feeling of panic with fear of impending death. A myocardial infarction indicates ischemia and necrosis have occurred to the affected part of the myocardium. Angina and myocardial infarction are different in that with myocardial infarction ischemia and necrosis occur to a portion of the myocardium. There are several types of angina; however, this response does not answer the patient's question.
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