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Understanding Angina: Symptoms, Types, and Treatment Strategies

Angina is sudden chest pain due to imbalanced blood flow and oxygen supply to the heart. Explore classic, unstable, and Prinzmetal’s angina types, and learn about treatment approaches such as increasing oxygen supply and reducing cardiac oxygen demand with medications like nitrates. Understand how nitrates work, their clinical uses, side effects, and drug interactions with erectile dysfunction medications. Discover the importance of calcium channel blockers and beta-blockers in managing hypertension. Stay informed about angina and its treatment options.

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Understanding Angina: Symptoms, Types, and Treatment Strategies

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  1. Angina

  2. Angina • Sudden substernal chest pain caused by imbalance btw blood flow and oxygen demands to the myocardium

  3. Normal Oxygen demands Oxygen supply Ischemia

  4. Types of angina • Classic (stable) angina: • 90% from the cases • Chest occuring upon exertion • Usually is due to atheromatous lesions • Unstable angina: • Occurs suddenly at rest • 10-20% progress to MI • Prizmetal’s (variant) angina: • Results from coronary vasospasm

  5. Treatment strategy of angina • Increase oxygen supply • Decrease cardiac oxygen demand

  6. Myocardial demands: • Preload • Diastolic filling pressure • Afterload • Peripheral vascular resistance • Heart rate • Wall tension

  7. Nitrates • Nitroglycerin • Isosorbide dinitrate • Isosorbide mononitrate

  8. Nitrates • Nitrates Release Nitric oxide Relaxation of smooth muscle Diminishes preload and afterload Dilation of veins

  9. Nitrates • At higher doses cause dilation of arteriols Decrease in peripheral resistance Decrease in blood pressure

  10. Clinical uses • Releive of acute attack • Sublingual form • Prevention of attack • Oral form or patch form • Cyanide poisoning

  11. Nitrates side effects • Postural hypotension • Reflex tachycardia • Throbbing headache • Flushes • Dizziness • Tolerance

  12. Drug interactions • Nitrates shouldn’t be used in conjunction with drugs used to erectile dysfunction

  13. Calcium channel blockers and beta blockers • Have been discussed in hypertension lecture

  14. Aspirin • Will be discussed later

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