Chapter 27 - Drugs for angina and MI.docx

Chapter 27 - Drugs for angina and MI.docx - Chapter 27...

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Chapter 27- drugs for angina and MI Coronary Artery disease (CAD): arteries that supply myocardium with nutrients/O2 Rt & Lt arise from Aortic sinuses diverge into smaller arteries that encircle heart Leading cause of death in USA Causes: o Narrowing/occlusion of coronary artery Deprives cells of O2/nutrients: myocardial ischemia Longtime = compensation for inadequate blood supply o May experience symptoms or not Eg) sometimes they are occluded by 50% with no symptoms Angina : Symptoms that occur over time o CAN lead to heart attack Etiology: o Most common atherosclerosis Plaque (fatty, fibrous material) in coronary arteries Causes narrowing of vessels Limits blood flow Impairs elasticity o Unable to dilate properly Especially during exercise Occurs gradually 40-50years Angina Pectoris: Chest pain caused by insufficient oxygen to portion of myocardium o Prevalent in pt over 55Yrs Crushing, constricting sensation o May radiate into left shoulder/arm/jaw/thoracic spine o May occur in mid-epigastrum o Overwhelming emotional distress panic, fear, dyspnea, pallor, tachycardia, elevated BP Short in duration o often subsides in 5-10 mins o esp with reduction of stress/exercise demands Women: o Not always have classic symptoms: Gastric distress, nausea, vomiting, burning sensation in chest/chest wall, overwhelming fatigue, sweating, Usually preceded by physical exertion/excitement o Increase Myocardial O2 demand Several types:
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o Stable Angina: predictable frequency, intensity, duration o Unstable Angina: more frequent, more intense, occur during resting periods A type of: “Acute coronary syndrome” o Vasospastic/Prinzmetal angina: dec Myocardial blood flow Caused by spasms of coronary arteries May or may not contain plaque Often during periods of rest May be unpredictable May be unrelated to rest o Silent Angina: Occurs in ABSENCE of chest pain One or more coronary arteries are occluded Remain ASSYMPTOMATIC High risk for MI/sudden death Remember: o Chest pain can be caused by OTHER disorders
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