CHAPTER 12

TREATMENT OF ANGINA PECTORIS

Difference with Angina Pectoris and Infarction
Angina Infarction
Partial obstruction Complete obstruction

Partial Obstruction: Rest (low need for oxygen and energy)

Angina Pectoris
-chest pain due to ischemia

Causes:
1. Atherosclerosis plaque/ obstruction “ ATHEROSCLEROTIC ANGINA”
2. Spasm (No plaque but muscle contracts) “VASOSPASTIC ANGINA”
3. Unknown (Angina at rest) “UNSTABLE ANGINA”

Root Cause of CHEST PAIN: Imbalance of supply and demand of O2

Determinants:
1. Heart rate (faster heart rate, higher demand)
2. Force of contraction
3. Wall stress ( ventricular wall is stressed, more demand of O2)

Tone of Blood vessel: governed by muscles

Contraction: higher need O2
Relaxation: lower need O2

Systole: cardiac contraction; gawas ang dugo (BV: artery)

Diastole: cardiac relaxation; sulod ang dugo (BV: vein)

DRUGS THAT CAUSES RELAXATION OF VASCULAR SMOOTH MUSCLES

1. Drugs that increases cGMP ex. Nitric oxide donors like Nitric Oxide
cGMP (cause dephosphorylation of myosin light chain)
No phosporylation= No contraction= No reaction with actin and myosin
Result: Muscle relaxation

2. Drug that decreases the intracellular Ca ex. Calcium channel blockers, Beta blocker
No Ca inside the cell= No contraction

3. Membrane stabilizing drugs

Drugs that are concerned with potassium
4. Drugs that increases cAMP