Welcome to pharmacology by Lecturio. I'm Dr. Pravin
J.Shukle and we are going to be talking about
heart failure management and angina management.
Let's take a look at this diagram.
Angina literally means pain in the chest. Typical
symptoms of angina are caused by narrowing of
blood vessels. Be very aware that angina doesn't
necessarily mean that the blood vessel is
completely blocked off. It just means that the
blood flow is restricted through a process
of atherosclerosis. Heart failure is when the
heart is not pumping enough blood to do its job.
You can have diastolic heart failure and systolic
heart failure. Diastolic heart failure is
the first stage of generalized heart failure.
What people don't realize about heart failure
and how the heart works is that the energy
consuming cycle of the heart is actually when it
opens up. That's a hard concept to understand.
I want you to think about a bow and arrow.
We put energy into the bow as we pull back on it,
and then at the right moment we let go of the string
and it pushes the arrow forward. The heart works
the same way. We put energy into the heart as it
opens up it waits for a signal and then it contracts.
Almost like an elastic recoil. Diastolic dysfunction
means that we don't have enough strength to open
up the arrow either quickly enough or enough
in terms of volume. Angina specifically is a reduced
blood flow because of narrowing of the blood vessels
of the heart. We put these two diseases together
because the treatment of both conditions often overlap.
Let's start with drugs used in angina. Angina can
be treated with vasodilators. These vasodilators
can be nitrates or calcium channel blockers like
verapamil. There are many types of nitric based treatments.
There are the short duration nitrates, the intermediate
duration nitrates and the long duration nitrates.
In terms of treating angina we do talk about
vasodilator activity of calcium channel blockers.
But there is another side to calcium channel
blockers. They are also cardiac depressants.
So they slow down the heart rate and reduce the
oxygen demand that the heart is asking for.
The other cardiac depressants are beta blockers.
We have other drugs that are used in angina as well.
Those are metabolism modifiers
and other rate inhibitors.
So these are the drugs that are used in angina.