CHD + anti-anginal drugs Flashcards
where does the left coronary artery supply blood to?
left and right side of heart (85% of coronary blood flow)
where does the right coronary artery supply blood to?
SAN, AVN and RHS of heart
where does venous blood return into?
coronary sinus and anterior cardiac vein
when is adenosine released?
when HR is high
which receptors does adenosine bind to + what is the effect?
adenosine-2A receptors
= increased cAMP
= vasodilation (increased CBF)
what happens when there’s an influx of K+?
hyperpolarisation
consequences of increased cardiac workload
- increased O2 consumption
- decrease pO2
-decrease ATP in coronary SM
-opening of ATP-sensitive K+ channels - increased cardiac AP frequency
- increase in extracellular K+
-activation of Na+ - K+ ATPase in coronary smooth muscle
= hyperpolarisation in coronary SM
= inhibition of L-VACCS
= vasodilation
what is angina/ischaemia?
reduced blood flow to heart
oxygen supply doesn’t meet oxygen demand = symptoms
underlying cause of angina
atheromatous disease of coronary arteries
symptoms of angina
chest pain
triggered by exercise or stress + stops within few minutes of resting
breathlessness, nausea + v. tired
symptomatic therapy for angina
reduce oxygen demand - reduce HR/cardiac preload
increase oxygen supply
lipid-lowering drugs to prevent progression of atheromatous disease
which type of drugs are the first line of treatment for angina?
beta blockers
calcium channel blockers
which type of drugs are the second line of treatment for angina?
organic nitrate vasodilators
nicorandil (possatium channel activator)
ivabradine (if current inhibitor)
ranolazine (inhibitor of cardiac late Na current)
name of beta blockers used for angina treatment
atenolol
acebutolol
pindolol
propranolol
labetalol
name of calcium channel blockers used for angina treatment
nifedipine
amlodipine
diltiazem
