《药理学》课程PPT教学课件（Cardiovascular Sys）29 treatment for angina pectoris

vasodilators & the treatment of angina pectoris

vasodilators & the treatment of angina pectoris

what is angina pectoris?symptom ofAngina pectoris is a common(CAD)byarterydiseasecausedcoronarytransient episodes of myocardial ischemia andanoxia.Pathophysiology of anginaAngina pectoris results from an imbalancebetween oxygen supply-demand relationship inischemic regions ofthemyocardium

what is angina pectoris? Angina pectoris is a common symptom of coronary artery disease (CAD) caused by transient episodes of myocardial ischemia and anoxia. Pathophysiology of angina Angina pectoris results from an imbalance between oxygen supply-demand relationship in ischemic regions of the myocardium

Key factors for oxygen demand includes:myocardial wall tensionintraventricular pressureventricular volumewall thicknessheart ratecontractility

Key factors for oxygen demand includes: myocardial wall tension intraventricular pressure ventricular volume wall thickness heart rate contractility

For oxygen supply includes:coronarybloodflowbloodpressureduration of diastolecoronary vascular bed resistance

For oxygen supply includes: coronary blood flow blood pressure duration of diastole coronary vascular bed resistance

The relationship of oxygendemand and oxgen supplyContractilityCoronaryOxygenOxygenHeartRateBlood FlowSupplyDemandLVWall TensionLVSystolicBPVolumeIschemiaChest PainArrhythmiasLV Dysfunction

The relationship of oxygen demand and oxgen supply Coronary Blood Flow Oxygen Supply Oxygen Demand Systolic BP LV Volume Contractility Heart Rate LV Wall Tension Arrhythmias Ischemia LV Dysfunction Chest Pain

Classification of angina pectoris patterns1. Stable angina (classical angina)the primary cause of angina pectoris is an imbalance between theoxygen requirement of the heart and the oxygen supplied to it viathe coronary vessels(such as stenosis of coronary arteries)2. Unstable angina (crescendo angina)unstable angina is caused by episodes of increased epicardialcoronary artery tone or small platelet clots occurring in thevicinity of an atherosclerotic plaque.3. Variant angina (prinzmetal's angina)variant angina is caused by spontaneous coronary spasm, eitherat work or at rest, rather than by increases in myocardial oxygenrequirements

Classification of angina pectoris patterns 1. Stable angina (classical angina) the primary cause of angina pectoris is an imbalance between the oxygen requirement of the heart and the oxygen supplied to it via the coronary vessels(such as stenosis of coronary arteries ). 2. Unstable angina (crescendo angina) unstable angina is caused by episodes of increased epicardial coronary artery tone or small platelet clots occurring in the vicinity of an atherosclerotic plaque. 3. Variant angina (prinzmetal’s angina) variant angina is caused by spontaneous coronary spasm, either at work or at rest, rather than by increases in myocardial oxygen requirements

The conditions can cause unstable anginaCoronary atherosclerosis2Coronary artery spasm3Transient platelet aggregationCoronary thrombosis5Endothelia injury causing the accumulation ofvasocontraction substances6Coronary vasocontraction following adrenergicstimulation

The conditions can cause unstable angina 1 Coronary atherosclerosis 2 Coronary artery spasm 3 Transient platelet aggregation 4 Coronary thrombosis 5 Endothelia injury causing the accumulation of vasocontraction substances 6 Coronary vasocontraction following adrenergic stimulation

Variant angina occurs at rest, at the sametime each day, and is usually due tocoronary artery spasm.: It is characterized by an elevated STsegment on the ECG during chest pain, andmay be accompanied by ventriculararrhythmias

• Variant angina occurs at rest, at the same time each day, and is usually due to coronary artery spasm. • It is characterized by an elevated ST segment on the ECG during chest pain, and may be accompanied by ventricular arrhythmias

Any way to relieve the chest pain?Any idea to ‘cure'the chest pain?

Any way to relieve the chest pain? Any idea to ‘cure’ the chest pain?

Awaywhichcankeepabalancebetweenoxygen supply-demand may ameliorateangina--relievethe pain.You can reduce oxygen demand or increaseoxygen supply or both to relieve the pain

• A way which can keep a balance between oxygen supply-demand may ameliorate angina-relieve the pain. • You can reduce oxygen demand or increase oxygen supply or both to relieve the pain