Angina and treatment principles/goals Flashcards Preview

CV PHARM...Antianginal > Angina and treatment principles/goals > Flashcards

Flashcards in Angina and treatment principles/goals Deck (5)
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1

Types

Unstable
Variant
Exertional

2

Variant (vasospastic, Prinzmetal's) angina

reduction in coronary flow due to vasospasm
(not increase in demand)

Normal coronary angiograms
--rarely catches spasm in action

excellent prognosis

3

approaches for treatment

1. increase blood flow (increase supply)
2. Reduce myocardial O2 consumption (demand)
--negative chronotropic effect (HR)
--negative inotropic effect (contractility)
--Decreased ventricular workload (wall stress)
......Reduced preload (venodilation)
......Reduced afterload (vasodilation)
3. prevent platelet deposition/aggregation
(aspirin)

4

To increase supply...

increase time spent in diastole
--negative chronotropy (decrease HR)

Squeeze the arteries less during systole
--negative inotropy (decrease contractility)

5

So, decreasing heart work (via decreasing HR or contractility) helps angina by...

1. decreasing demand
2. increasing supply