Category: Fundamentals The sublingual forms of NTG are rapid acting. These medications are used for acute attacks of angina. To be effective, NTG must be administered sublingually to avoid hepatic first-pass metabolism, which would inactivate the medication.
Category: Fundamentals Nitrates do not directly influence the chronotropic or inotropic actions of the heart, so their administration does not affect or alter cardiac function but rather decreases the work of the heart and increases myocardial oxygenation.
Category: Fundamentals Nitrates and their analogs are potent agents and have profound effects on vascular smooth muscle. The nitrates cause dilation throughout the vasculature - in the peripheral arteries and veins as well as the coronary arteries.
Category: Fundamentals Due to the effects on angiotensin II and aldosterone, ACE inhibitors contribute to potassium retention as sodium is preferentially excreted. This raises the possibility of a hyperkalemia state for the patient and must be monitored routinely.
Category: Fundamentals Side effects of ACE inhibitors are uncommon but may include an irritating cough and excessive drops in blood pressure, particularly in hypovolemic patients or those already on diuretics. Hyperkalemia may also occur.
Category: Fundamentals Angiotensin II is a potent vasoconstrictor and also stimulates aldosterone secretion. Blocking the production of angiotensin II results in reduced vasoconstriction and sodium and water retention, thus reducing preload, afterload and ejection fraction.
Category: Fundamentals ACEIs affect the enzyme responsible for the conversion of angiotensin I to angiotensin II. ARBs block vasoconstriction and aldosterone effects of angiotensin II by selectively blocking angiotensin II from binding to angiotensin II receptors.
Category: Fundamentals The treatment goals for the management of angina include relieving the acute anginal episode, preventing additional anginal episodes, preventing progression of CHD, reducing the risk of MI, improving functional capacity and prolonging survival.
Category: Fundamentals Ischemic episodes that result in anginal pain are usually activated by two situations occurring simultaneously or independently: (1) ambient factors that increase myocardial oxygen demand and (2) circumstances that decrease oxygen supply.
Category: Fundamentals A less common cause of restricted coronary blood supply may be coronary vasospasm, a narrowing of the coronary artery lumen. This narrowing is produced by an arterial muscle spasm and limits the blood supply to the myocardium.
Category: Fundamentals Atherosclerosis primarily affects the intima of the arterial wall. It normally takes years to develop. Coronary heart disease progresses through three developments the fatty streak, the fibrous plaque and the complicated lesion.
Category: Fundamentals The pathophysiology of angina involves atherosclerosis, a disorder of lipid metabolism resulting in the deposit of cholesterol in the blood vessel. This causes a reactive endothelial injury that eventually results in a narrowing of the vessels.
Category: Fundamentals Cardiovascular disease is the most common cause of death in patients with diabetes. In fact, patients with diabetes have the same risk of having an MI as a patient who already has a history of an MI.
Category: Fundamentals Cardiovascular disease is the most common cause of death in patients with diabetes. In fact, patients with diabetes have the same risk of having an MI as a patient who already has a history of an MI.
Category: Fundamentals Hypertension is a major risk factor for CHD and can lead to vascular complications that increase morbidity and mortality. Additionally, the higher the blood pressure, the higher the risk of MI and other cardiovascular events.
