Treatment of Angina Flashcards

1
Q

When does perfusion of the heart muscle occur and why?

A

During diastole, due to the rebound effect the blood has on the aortic valve

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2
Q

What factors shorten diastole?

A

Exercise and increased HR

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3
Q

What type of pathology causes an increase in end diastolic pressure?

A

Faulty valves, meaning more residual blood is left in the ventricles following systole

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4
Q

What does coronary ischaemia normally result from?

A

Atherosclerosis

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5
Q

What does sudden ischaemia normally result from?

A

Thrombosis

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6
Q

What can coronary spasms cause?

A

Angina

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7
Q

On a cellular level, what can ischaemia cause?

A

Cellular calcium overload leading to cell death and dysrhythmias

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8
Q

What can cause inadequate supply of O2 to the heart (angina pectoris)?

A

Changes from hot to cold and vice versa
Exercise
Increased adrenaline
Other local factors

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9
Q

Even if an atherosclerotic plaque doesn’t completely occlude the artery, why is it still dangerous?

A

Flow is so greatly reduced that O2 reaching the heart is reduced

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10
Q

Name the 3 types of angina.

A

Printzmetal’s Variant Angina
Chronic Stable Angina
Unstable Angina

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11
Q

What is chronic stable angina caused by?

A

Fixed narrowing of the coronary arteries causing predictable chest pain upon exertion

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12
Q

What is variant angina caused by?

A

Coronary spasms

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13
Q

Name the two methods by which angina treating drugs work?

A

Vasodilators

Slows down the heart which decreases the metabolic demands of the coronary muscle

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14
Q

What type of Ca2+ channels do calcium antagonists prevent the opening of?

A

L type

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15
Q

See slide 12

A

For deets

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16
Q
Which of the following drugs are safe for use in patients suffering with heart failure?
Amlodipine
Verapamil
Lercanidipine
Diltiazem
A

Amlodipine

Lercanidipine

17
Q

List some side effects of angina treatment drugs.

A

Headaches
Constipation
Ankle oedema

18
Q

What is the action of glyceryl trinitrate and isosorbide mononitrate?

A

Vasodilators; work by being metabolised to nitric oxide and relax smooth muscle, in turn decreasing preload.
They also dilate collateral coronary vessels, improving distribution of coronary blood flow towards ischaemic areas

19
Q

What are some common side effects of organic nitrate treatment?

A

Headache

Postural hypotension

20
Q

Describe the mechanism of action of ivabradine.

A

Inhibits funny ‘f’ type channels in the heart, reducing the pacemaker activity (pacemaker potential slope decreases, meaning depolarisation takes longer to ensue and heart rate is reduced