Angina

Question 1

name 4 substances that affect CHF

Answer 1

adenosine, potassium, hypoxia and catecholamines

Question 2

how does adenosine affect the CHF

Answer 2

increased HR = increased adenosine = increased cAMP = vasodilation = increased CBF

Question 3

is there a negative feedback system?

Answer 3

yes, increased adenosine, shows negative feedback and ultimately acts to lower the heart rate

Question 4

what is the underlying cause of angina

Answer 4

atheromatous disease of the coronary arteries which means there is a decreased coronary blood flow, so not enough oxygen supply to match the demand

Question 5

what is myocardial ischaemia

Answer 5

blood flow to your heart is reduced, preventing the heart muscle from receiving enough oxygen. The reduced blood flow is usually the result of a partial or complete blockage of your heart’s arteries (coronary arteries).

Question 6

what is stable angina caused by

Answer 6

partial narrowing of the carotid artery

Question 7

what is unstable angina caused by

Answer 7

plaque rupturing and platelet aggregation

Question 8

what can cause myocardial infarction

Answer 8

coronary thrombosis

Question 9

fist line treatment for stable angina

Answer 9

reduce O2 demand/increase O2 supply, lipid lowering drugs

Question 10

examples of first line therapy used to treat stable angina

Answer 10

beta blockers and calcium channel blockers

Question 11

name a beta1 selective beta blocker

Answer 11

atenolol

Question 12

name a Ca channel blocker

Answer 12

nifedipine and amlodipine

Question 13

diltiazem coupled with a beta blocker could cause

Answer 13

severe bradycardia and AV block and reduced cardiac contractility

Question 14

what is the second line therapies used?

Answer 14

organic nitrate vasodilators, K channel activators

Question 15

name 2 drugs that can inhibit the funny current

Answer 15

ivabradine and ranolazine

Question 16

how does GTN work

Answer 16

The narrowing makes it more difficult for blood to flow to your heart muscle. GTN works in two ways. It relaxes blood vessels in your body (causing them to widen) and this reduces the strain on your heart, making it easier for your heart to pump blood around your body

Question 17

drug that effects venous return, decreasing cardiac preload, causes venodilation and arteriodilation

Answer 17

nicorandil

Question 18

selective inhibitor of the funny current in the pacemaker AP

Answer 18

ivabradine

Question 19

what effect does ivabradine have on the heart rate

Answer 19

decrease it

Question 20

when can’t you use ivabradine?

Answer 20

with Ca channel blockers = bradycardia

Question 21

2 main consequences of unstable angina

Answer 21

NSTEMI and STEMI

Question 22

which is worse, an NSTEMI or STEMI

Answer 22

STEMI

Question 23

what is an NSTEMI

Answer 23

partial artery occlusion

Question 24

what is a STEMI

Answer 24

complete artery block

Question 25

what causes unstable angina

Answer 25

myocardial ischaemia due to thrombosis formation in a coronary artery