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The Human
Heart
What is Angina
Pectoris?
Angina pectoris (stable angina) is the
medical term for chest pain or
discomfort that results from reduced
coronary blood flow, causing a
temporary imbalance between
myocardial body supply and demand.
Angina isn't a disease; it is a symptom
of an underlying heart problem.
Pathophysiology
Coronary
atherosclerosis
Exposure to
cold
vasoconstrict
ion
elevated
blood
pressure
Stress or
any
emotionprovoking
situation
Physical
exertion
increasing
myocardial
oxygen demand
anemi
a
significant
obstruction of a
major coronary
artery
reduced
coronary
blood flow
imbalance
between
myocardial
oxygen supply
and demand
Eating a
heavy
meal
increases the blood
flow to the
mesenteric area for
digestion
hypovole
mia
smoki
ng
release of
catecholamin
es
increases
blood
pressure
and heart
rate
Increase
myocard
ial
workloa
d
anaerobic metabolism
replaces aerobic
metabolism for
nourishment
produces lactic
acid
factor P is
released from
ischemic
myocardial cells
the heart muscle
does not have any
pain fibers
pain is felt
wherever
substance P
reacts with a
pain receptor
poorly localized pain and may
radiate to the neck, jaw,
shoulders, and inner aspects of
the upper arms, usually the left
Angina Pectoris
Other symptoms:
Weakness or
numbness in the
arms, wrists, and
hands may
accompany the
pain
Shortness of breath
Pallor
Diaphoresis
Dizziness or lightheadedness
Nausea and
Mechanism of Action:
Nitrates cause blood vessels to relax and dilate. This results in a drop in
peripheral resistance and blood pressure and a decrease in venous return
to the heart. These actions will decrease myocardial workload and can
restore the appropriate balance in the supply demand ratio in the heart.
Mechanism of Action:
Calcium channel blockers reduce myocardial oxygen
demand and increase myocardial blood and oxygen
supply, lowering blood pressure and reducing
myocardial contractility and heart rate. They are also
potent coronary vasodilators which increases oxygen
supply.