CVS - Ischemic Heart Disease and Treatment Flashcards
What are the types of angina associated with ischemic heart disease?
Atherosclerotic, Vasospastic, and Unstable Angina.
What factors determine cardiac oxygen requirement?
Preload, heart rate, afterload, and cardiac contractility.
What is the therapeutic aim of vasodilators in angina treatment?
To decrease cardiac oxygen demand and increase oxygen supply.
What is the mechanism of action of nitrates in IHD?
They cause vasodilation, reducing myocardial oxygen demand.
How are glycerol nitrates used in acute angina treatment?
They provide rapid relief from angina by dilating coronary arteries.
What are the pharmacokinetics of isosorbide dinitrate and mononitrate?
They are long-acting nitrates, metabolized in the liver, with prolonged effects.
What are common side effects of nitrates?
Headache, hypotension, reflex tachycardia, and venous dilation.
How do beta-blockers work in treating IHD?
They reduce heart rate and contractility, lowering myocardial oxygen demand.
What are the effects of dihydropyridine calcium channel blockers on blood pressure?
They cause vasodilation, leading to a decrease in blood pressure.
What is the mechanism of action of ivabradine in IHD treatment?
It reduces heart rate by inhibiting the If channel in the sinoatrial node.
Which drugs are used for treating hypertension in IHD patients?
Diuretics, beta-blockers, ACE inhibitors/ARBs, and calcium channel blockers.
How do non-dihydropyridine calcium channel blockers aid in IHD treatment?
They decrease heart rate and contractility, reducing oxygen demand.
What is the role of preload in cardiac oxygen requirement?
Higher preload increases oxygen demand due to an increased volume of blood.
How does afterload affect cardiac oxygen requirement?
Higher afterload increases oxygen demand due to increased vascular resistance.
What are vasorelaxation side effects in nitrate therapy?
Vasorelaxation can cause dizziness and orthostatic hypotension.
What is the effect of reflex tachycardia in nitrate therapy?
It can counteract the benefits of vasodilation by increasing heart rate.
How do beta-blockers affect exercise-induced angina?
They reduce the frequency and severity of exercise-induced angina.
What are the potential side effects of beta-blockers in IHD?
Fatigue, bradycardia, bronchospasm, and worsening of peripheral vascular disease.
What is the clinical use of isosorbide mononitrate in IHD?
It’s used for long-term prophylactic management of angina.
How do dihydropyridines differ from non-DHP calcium channel blockers?
Dihydropyridines primarily cause vasodilation, while non-DHPs also affect the heart rate and force of contraction.
What is a unique feature of ivabradine compared to other antianginal drugs?
It specifically targets heart rate without affecting blood pressure or myocardial contractility.
In what conditions are beta-blockers contraindicated in IHD?
Asthma, severe bradycardia, and advanced heart block.
How does vasospastic angina differ from atherosclerotic angina?
Vasospastic angina is caused by coronary artery spasms, while atherosclerotic angina is due to plaque buildup.
What is the significance of unstable angina in IHD?
It indicates a high risk of myocardial infarction and requires immediate medical attention.
Why is meningeal artery vasodilation a concern in nitrate therapy?
It can lead to headaches, a common side effect of nitrates.
How do calcium channel blockers help in vasospastic angina?
They prevent or relieve coronary artery spasms.
What are the adverse effects of calcium channel blockers in IHD?
Peripheral edema, constipation (with non-DHPs), and dizziness.
What is the main disadvantage of short-acting nitrates?
They may cause tolerance, reducing their effectiveness over time.
Why is monitoring renal function important in IHD patients on diuretics?
To prevent renal impairment and electrolyte imbalances.
How do ACE inhibitors/ARBs benefit IHD patients with hypertension?
They reduce blood pressure and have protective effects on the heart and kidneys.
What is the relevance of cardiac depressants in angina therapy?
They reduce myocardial oxygen demand by decreasing heart rate and contractility.
Why is cardiac pacemaker retardant therapy used in IHD?
To slow the heart rate, reducing myocardial oxygen demand and improving oxygen supply.
What is the therapeutic effect of nitrates in acute angina?
Rapid relief of chest pain by dilating coronary arteries and reducing preload.
How do beta-blockers improve survival in IHD patients?
By reducing the risk of arrhythmias and myocardial infarction.
What is the first-line treatment for chronic stable angina?
Beta-blockers, due to their effectiveness in reducing angina frequency and severity.
Why is patient education important in nitrate therapy?
To ensure proper use, prevent tolerance, and manage side effects.
What lifestyle modifications are recommended for IHD patients?
Smoking cessation, dietary changes, and regular exercise.
How do aldosterone antagonists contribute to IHD treatment?
By reducing fluid overload and myocardial fibrosis.
Why should IHD patients avoid sudden discontinuation of beta-blockers?
To prevent rebound hypertension and worsening angina.
How do SGLT2 inhibitors benefit IHD patients with diabetes?
They improve glycemic control and reduce cardiovascular risk.
Why is monitoring blood pressure essential in IHD patients on vasodilators?
To prevent excessive hypotension and syncope.
What is the role of diuretics in IHD treatment?
To reduce preload and alleviate symptoms of heart failure.
How do ARBs differ from ACE inhibitors in their mechanism of action?
ARBs block angiotensin II receptors, while ACE inhibitors prevent the formation of angiotensin II.
What are the indications for using ivabradine in IHD?
To reduce angina frequency and improve exercise tolerance in patients intolerant to beta-blockers.
What are the contraindications for calcium channel blocker use in IHD?
Severe hypotension, heart block, and heart failure with reduced ejection fraction.
What is the primary symptom of ischemic heart disease?
Angina pectoris.
What is the main goal of treatment in ischemic heart disease?
To reduce myocardial oxygen demand.
How do ?-blockers help in IHD?
They decrease heart rate and contractility.
What is the role of calcium channel blockers in IHD?
They reduce systemic vascular resistance and myocardial contractility.
How do nitrates help in IHD?
By producing venous dilation, decreasing preload, and thus oxygen demand.
What is the effect of lipid-lowering drugs in IHD patients?
They reduce the risk of heart attacks.
How is unstable angina treated in IHD?
With nitroglycerin, antiplatelet, and anticoagulant drugs.
What is the treatment for acute myocardial infarction in IHD?
Thrombolytic agents, and direct reversible P2Y12 receptor antagonists.
How do organic nitrates work?
They are sources of nitric oxide (NO), leading to vasodilation.
What is the administration route of nitroglycerin for rapid onset?
Sublingually, to avoid first-pass metabolism.
What are common side effects of nitroglycerin?
Headache, orthostatic hypotension, and tachycardia.
How is heart failure related to ischemic heart disease?
It is often a consequence of IHD, among other causes.
What is the common cause of heart failure?
Ischemic heart disease, arterial hypertension, valvular diseases, and others.
How do antiplatelet drugs help in IHD?
By preventing thrombus formation in the coronary arteries.
What are the benefits of ?-blockers in exertional angina and post-MI?
They are effective in reducing angina and improving survival post-myocardial infarction.
