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Questions and Answers
Which CYP 3A4 inhibitor is classified as a papaverine derivative with higher affinity for the heart?
Which CYP 3A4 inhibitor is classified as a papaverine derivative with higher affinity for the heart?
What adverse effect is associated with non-dihydropyridine (Non-DHP) calcium channel blockers?
What adverse effect is associated with non-dihydropyridine (Non-DHP) calcium channel blockers?
Which medication is a late sodium current blocker and exerts antianginal and anti-ischemic effects without changing hemodynamic parameters?
Which medication is a late sodium current blocker and exerts antianginal and anti-ischemic effects without changing hemodynamic parameters?
Which calcium channel blocker has the highest affinity for the heart?
Which calcium channel blocker has the highest affinity for the heart?
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What is the most common cause of stable angina?
What is the most common cause of stable angina?
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How is stable angina diagnosed?
How is stable angina diagnosed?
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Which medication decreases the oxygen demands of the heart by slowing the heart rate and reducing the force of the heart muscle contraction?
Which medication decreases the oxygen demands of the heart by slowing the heart rate and reducing the force of the heart muscle contraction?
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What is a characteristic feature of unstable angina on ECG?
What is a characteristic feature of unstable angina on ECG?
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What is the recommended treatment for unstable angina?
What is the recommended treatment for unstable angina?
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What is the mechanism of action of nitrates in stable angina?
What is the mechanism of action of nitrates in stable angina?
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Which condition is more likely to lead to a myocardial infarction?
Which condition is more likely to lead to a myocardial infarction?
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Which medication has not been proven to decrease the risk for heart attack and death in unstable angina?
Which medication has not been proven to decrease the risk for heart attack and death in unstable angina?
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What is the prime determinant of Silent Ischemia?
What is the prime determinant of Silent Ischemia?
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What is the main goal of antianginal drug treatment?
What is the main goal of antianginal drug treatment?
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What is the pathophysiological cause of Angina Pectoris?
What is the pathophysiological cause of Angina Pectoris?
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What is the classification basis for Acute Coronary Syndrome?
What is the classification basis for Acute Coronary Syndrome?
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What is the primary treatment for ALL types of Ischemic Heart Disease?
What is the primary treatment for ALL types of Ischemic Heart Disease?
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What is the main determinant of Ischemic Heart Disease?
What is the main determinant of Ischemic Heart Disease?
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What is the characteristic symptom of Angina Pectoris?
What is the characteristic symptom of Angina Pectoris?
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What is the duration of an Angina attack?
What is the duration of an Angina attack?
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What is the mechanism of action of ranolazine (Ranexa)?
What is the mechanism of action of ranolazine (Ranexa)?
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Which adverse effect is associated with non-dihydropyridine (Non-DHP) calcium channel blockers?
Which adverse effect is associated with non-dihydropyridine (Non-DHP) calcium channel blockers?
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What is the prime determinant of Silent Ischemia?
What is the prime determinant of Silent Ischemia?
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Which medication is contraindicated in Atrioventricular Block (AV Block) due to its effect on heart rate through the AV node?
Which medication is contraindicated in Atrioventricular Block (AV Block) due to its effect on heart rate through the AV node?
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What is the most common cause of stable angina?
What is the most common cause of stable angina?
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What is the mechanism of action of nitrates in stable angina?
What is the mechanism of action of nitrates in stable angina?
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What is the characteristic feature of unstable angina on ECG?
What is the characteristic feature of unstable angina on ECG?
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What is the recommended treatment for unstable angina?
What is the recommended treatment for unstable angina?
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What is the prime determinant of Silent Ischemia?
What is the prime determinant of Silent Ischemia?
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Which medication has not been proven to decrease the risk for heart attack and death in unstable angina?
Which medication has not been proven to decrease the risk for heart attack and death in unstable angina?
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What is the main goal of antianginal drug treatment?
What is the main goal of antianginal drug treatment?
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What is the classification basis for Acute Coronary Syndrome?
What is the classification basis for Acute Coronary Syndrome?
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What is the main goal of antianginal drug treatment?
What is the main goal of antianginal drug treatment?
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What is the prime determinant of Silent Ischemia?
What is the prime determinant of Silent Ischemia?
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What is the classification basis for Acute Coronary Syndrome?
What is the classification basis for Acute Coronary Syndrome?
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What is the characteristic symptom of Angina Pectoris?
What is the characteristic symptom of Angina Pectoris?
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Which medication decreases the oxygen demands of the heart by slowing the heart rate and reducing the force of the heart muscle contraction?
Which medication decreases the oxygen demands of the heart by slowing the heart rate and reducing the force of the heart muscle contraction?
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What is the duration of an Angina attack?
What is the duration of an Angina attack?
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What is the most common cause of stable angina?
What is the most common cause of stable angina?
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What is the pathophysiological cause of Angina Pectoris?
What is the pathophysiological cause of Angina Pectoris?
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Which medication used for the treatment of angina is contraindicated with phosphodiesterase-5 (PDE-5) inhibitors due to the risk of extreme hypotension and death?
Which medication used for the treatment of angina is contraindicated with phosphodiesterase-5 (PDE-5) inhibitors due to the risk of extreme hypotension and death?
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Which medication is the drug of choice for prompt relief and prophylaxis of stable or vasospastic angina?
Which medication is the drug of choice for prompt relief and prophylaxis of stable or vasospastic angina?
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Which calcium channel blocker has a higher affinity for the peripheral vessels and can cause gingival hyperplasia and hypotension?
Which calcium channel blocker has a higher affinity for the peripheral vessels and can cause gingival hyperplasia and hypotension?
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Which medication, when used in patients with asthma, requires caution due to its potential to worsen the condition?
Which medication, when used in patients with asthma, requires caution due to its potential to worsen the condition?
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Which medication should not be used in heart failure patients due to the risk of exacerbating edema?
Which medication should not be used in heart failure patients due to the risk of exacerbating edema?
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Which medication must be discontinued gradually over 5-10 days to avoid rebound angina or hypertension?
Which medication must be discontinued gradually over 5-10 days to avoid rebound angina or hypertension?
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Which medication causes the formation of Nitric oxide (NO) leading to activation of guanylate cyclase, increasing cGMP, and relaxation via dephosphorylation of myosin light chains?
Which medication causes the formation of Nitric oxide (NO) leading to activation of guanylate cyclase, increasing cGMP, and relaxation via dephosphorylation of myosin light chains?
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Which calcium channel blocker has a higher affinity for the heart and can cause negative inotropy due to slowing of SA and AV node conduction?
Which calcium channel blocker has a higher affinity for the heart and can cause negative inotropy due to slowing of SA and AV node conduction?
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Which medication, due to its mechanism of action, is not used for vasospastic angina and may worsen such attacks by blocking some β2 receptors that produce vasodilator effects?
Which medication, due to its mechanism of action, is not used for vasospastic angina and may worsen such attacks by blocking some β2 receptors that produce vasodilator effects?
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Which medication, due to its mechanism of action, is contraindicated in brittle diabetics and heart block patients?
Which medication, due to its mechanism of action, is contraindicated in brittle diabetics and heart block patients?
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Which medication, when used in patients with a history of syncope and age ≥ 65, requires caution due to its potential to exacerbate episodes of syncope?
Which medication, when used in patients with a history of syncope and age ≥ 65, requires caution due to its potential to exacerbate episodes of syncope?
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Study Notes
CYP 3A4 Inhibitor
- Dronedarone is a papaverine derivative with higher affinity for the heart
Calcium Channel Blockers
- Non-dihydropyridine (Non-DHP) calcium channel blockers are associated with bradycardia
- Verapamil has the highest affinity for the heart
Angina
- Stable angina is most commonly caused by atherosclerosis
- Diagnosis of stable angina is through electrocardiogram (ECG) and exercise tolerance test
- Ivabradine decreases the oxygen demands of the heart by slowing the heart rate and reducing the force of the heart muscle contraction
- Unstable angina is diagnosed by ECG with ST-segment depression or elevation
- Recommended treatment for unstable angina includes antiplatelet therapy and beta blockers
- Nitrates decrease oxygen demands of the heart by vasodilation, reducing preload and subsequently workload of the heart
Ischemic Heart Disease
- Prime determinant of Silent Ischemia is impaired glucose tolerance
- Main goal of antianginal drug treatment is to reduce frequency and severity of angina attacks
- Pathophysiological cause of Angina Pectoris is imbalance between oxygen supply and demand
- Classification basis for Acute Coronary Syndrome is existence of myocardial necrosis
- Primary treatment for ALL types of Ischemic Heart Disease is antiplatelet therapy and statins
- Main determinant of Ischemic Heart Disease is coronary atherosclerosis
- Characteristic symptom of Angina Pectoris is chest pain or discomfort
- Duration of an Angina attack is usually 5-30 minutes
Medications
- Ranolazine (Ranexa) is a late sodium current blocker exerting antianginal and anti-ischemic effects
- Beta blockers are contraindicated in Atrioventricular Block (AV Block) due to its effect on heart rate through the AV node
- Organic nitrates decrease oxygen demands of the heart by vasodilation, reducing preload and subsequently workload of the heart
- Phosphodiesterase-5 (PDE-5) inhibitors are contraindicated with nitrates due to the risk of extreme hypotension and death
- Nitroglycerin is the drug of choice for prompt relief and prophylaxis of stable or vasospastic angina
- Verapamil can cause gingival hyperplasia and hypotension
- Beta blockers require caution in asthma patients due to potential to worsen the condition
- Hydralazine should not be used in heart failure patients due to the risk of exacerbating edema
- Beta blockers must be discontinued gradually over 5-10 days to avoid rebound angina or hypertension
- Nitrates cause the formation of Nitric oxide (NO) leading to activation of guanylate cyclase, increasing cGMP, and relaxation via dephosphorylation of myosin light chains
- Verapamil has a higher affinity for the heart and can cause negative inotropy due to slowing of SA and AV node conduction
- Beta blockers are not used for vasospastic angina and may worsen such attacks by blocking some β2 receptors that produce vasodilator effects
- Beta blockers are contraindicated in brittle diabetics and heart block patients due to its mechanism of action
- Ivabradine requires caution in patients with a history of syncope and age ≥ 65 due to its potential to exacerbate episodes of syncope
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Description
Test your knowledge of variant (Prinzmetal) angina with this quiz. Explore the symptoms, triggers, and diagnostic features of this form of angina, also known as vasospastic angina.
