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# Angina - **Tx aims to:** frequency, duration, intensity of pain - **Oft inability to meet demands, no O2 + nutrients =** muscle aches = "angina pectoris" ## 2 Issues: - **Ischemic heart disease -** poor blood supply - **MI -** blockage ### Types: 1. **Chronic -** triggered by exertion, predicta...

# Angina - **Tx aims to:** frequency, duration, intensity of pain - **Oft inability to meet demands, no O2 + nutrients =** muscle aches = "angina pectoris" ## 2 Issues: - **Ischemic heart disease -** poor blood supply - **MI -** blockage ### Types: 1. **Chronic -** triggered by exertion, predictable pain subsides ~15 minutes of rest 2. **Unstable -** acute coronary syndrome, unpredictable 3. **Vasospastic -** can occur with or without exertion, at rest without a trigger # Drugs: ### 1. Nitrates & Nitrites: - **BP** - **Potent vasodilator** - **Relaxes vascular smooth muscle** - **Nitroglycerin** - **Rapid & long acting** - **Ideal for ischemia** - **Burning sensation -** its working ### 2. Beta Blockers: - **VHR** - **Block Beta -** no cardiac stimulation = VHR & O2 demand - **Delivery to heart now & contractility** - **After MI, catecholamines irritate -** they block these effects, improving survival ### 3. Calcium Channel Blockers (CCB): - **Relax blood vessels** - **Block calcium channel -** relaxation by vasodilation - **SVR - workload - O2 demand & blood flow to ischemic** - **Resolves angina.** - **Good for afib/flutter with paroxysmal supraventricular tachycardia -** "Chainy on and off suddenly" **Sildenafil (viagra):** - **Different severe risk for hypotension.** - **With continuous use.** - **Patches -** tolerance