Heart Disease and Stroke Flashcards
What is Angina pectoris?
Crushing pain in chest that may radiate to arm, neck or jaw
- Most commonly on exertion.
The pain results from cardiac ischemia.
What are the pathophysiological problems in CHD?
- narrowing of coronary arteries by atheroma (fatty gunge)
- so not enough oxygen reaches heart muscle,
- so oxygen DEMAND exceeds SUPPLY,
- So heart muscle is HYPOXIC
What do nitrates do?
Produce Nitric oxide which causes vascular smooth muscle to relax.
List side effects of nitrates…
- Throbbing headache - cerebral vasodilatation
- Dizziness (esp. on getting up) – lowered blood pressure
What are statins classed as?
Lipid lowering drugs.
List side effects of statins…
- GI upset (usually wears off)
- abnormal liver tests (usually mild)
- muscle problems (myopathy – rare but serious)
What are the 2 causes of a stroke?
- Embolism from distant site
2. Thrombosis -> occlusion; usually in atheromatous carotid, vertebral or cerebral artery
What is plasmin?
Body’s own “clot-buster” degrades fibrin.
What is the only drug currently licensed for use in acute ischaemic stroke?
Alteplase
What are the targets for modifying thrombosis process?
Modify coagulation:
most successful in venous thrombosis
Modify platelet aggregation:
important in arterial thrombosis
Modify clot, thrombus breakdown:
after prophylaxis fails
What is Aspirin ?
Non steroidal anti-inflammatory drug.
→ Inhibits cyclo-oxygenase (COX1).
→ Prevents thromboxane formation
List the 3 drugs used in the antiplatelet regime …
Aspirin + dipyridamole, or clopidogrel
The “clotting cascade” is triggered when…
When blood contacts damaged tissue or exposed collagen.
What does thrombin do?
Converts fibrinogen into fibrin
How does Heparin work?
activates one of the body’s own anti-clotting molecules, antithrombin III.
