stable coronary disease Flashcards
where does the problem with circulation
in the heart arise from
microcirculation
stable angina
predictable chest pain that is brought about by emotional stress which increase myocardial oxygen demand.
atypical angina
Defined as stable angina but with symptoms not clearly identifiable as ischaemic chest pain. Breathlessness
Burning/reflux/burping
modifiable risk factors for angina
hypertension
smoking
diabetes
hyperlipidaemia
non-modifiable
family history
post -menopausal females
male
other arterial disease
what is angina
pain in the heart that is caused by supply demand mismatch
how to tackle angina
prevent the load that is put on the heart
how to prevent the load of the heart
CO=HR *SV
reduce heart rate , reduce stroke volume ,
reduce heart rate by introducing beta blockers , reduce sv by regulating resistance and afterload
what ar
what are factors that affect the supply of the heart
coronary artery diameter
blood flow to the coronary outflow
perfusion pressure , heart rate that is the duration of diastole.
what are the determinants of demand
heart rate , systolic blood pressure , myocardial wall stress , myocardial contractility
what are the aims of acs medication
relieving symptoms
slowing disease progression
preventing myocardial infarction
preventing premature death
medication for relieving symptoms
rate limiting drugs
vasodilators
example of rate limiting drugs
calcium channel blocker l type
calcium channel blockers f type
beta -adrenoreceptor antagonist
example of vasodilators
(reduce blood pressure )
nitrates
calcium channel blockers
potassium channel activators
examples of anti-platelets
aspirin
clopidogrel
ticagrelor
prasugrel
examples of cholesterol lowering drugs
HMG -Coa reductase inhibitors which aim to reduce synthesis of cholesterol
Fibrates
PCSK-9 inhibitors -
action of fibrates
stimulate uptake of fatty acid
action of aspirin
inhibits cox enzyme which leads to no production of prostaglandins
examples of antiplatelets
aspirin
clopidogrel
ticagrelor
prasugrel
action of beta-adrenoreceptor antagonist
they block beta 1 and 2 ; sympathetic nervous system is also blocked with the antagonist.
this could be selective or non -selective
cardio -selective beta antagonists
bisoprolol
metoprolol which is shorter acting
non selective beta antagonists
carvedilol
propranolol
side effects of beta adrenoreceptor antagonists
asthma from non selective
peripheral vascular disease
acute heart failure
bradycardia or heart block
fatigue
impotence
