Stable angina

Hypercholesterolemic patients undergoing quantitative angiography before/after lipid-lowering therapy Acute coronary syndromes AMI, unstable angina, stable CAD, healthy controls Patients with stable angina pectoris undergoing PCI... 

Verapamil. Verapamil hydrochloride is a pbenyl alkyl amine and is considered the prototype of the Class I calcium channel blockers. Verapamil is also a potent inhibitor of coronary artery spasm and is useful in Prinzmetal s angina and in unstable angina at rest. Verapamil produces negative chronotropic and inotropic effects. These two actions reduce myocardial oxygen consumption and probably account for the effectiveness of verapamil in chronic stable effort angina (98,99). Moreover, verapamil is an effective antihypertensive agent. 

Nadolol. Nadolol (Table 3) is a hydrophilic, nonselective -adrenoceptor blocking agent having no ISA and no membrane-stabilizing activity. It is useful for the treatment of hypertension and chronic stable exertional angina (98,99,108). 

Procardia XL. Procardia XL extended-release capsules, marketed by Pfizer Labs Division of Pfizer, Inc., contain nifedipine [21829-25-4] a calcium channel blocker of mol wt 346.3. The extended release tablet is formulated as a once-a-day controlled release capsule for oral adrninistration dehvering either 30, 60, or 90 mg nifedipine. Procardia XL is indicated for use in the management of vasospastic angina, chronic stable angina, and hypertension (see Cardiovascularagents). 

Nitroglycerin has long been used for the treatment of acute attack of angina pectoris, and its stable analogs are available to prevent the anginal attack. Nitrovaso-dilators such as sodium nitropmsside liberate NO from their molecules in the tissue (thus, called NO donors) and elicit actions via cyclic GMP like those seen with endogenously synthesized NO. 

Differentiate between the pathophysiology of chronic stable angina and acute coronary syndromes. 

O Ischemic heart disease results from an imbalance between myocardial oxygen demand and oxygen supply that is most often due to coronary atherosclerosis. Common clinical manifestations of ischemic heart disease include chronic stable angina and the acute coronary syndromes of unstable angina, non-ST-segment elevation myocardial infarction, and ST-segment elevation myocardial infarction. 

Patients with chronic stable angina will generally be in no acute distress. In patients presenting in acute distress, the clinician should be suspicious of ACS. 

Findings on the physical exam are often normal in patients with chronic stable angina. However, during episodes of ischemia, patients may present with abnormal heart sounds, such as paradoxical splitting of the second heart sound, a third heart sound, or a loud fourth heart sound. 

Biochemical markers (creatine kinase [CK], CK-MB fraction, troponin I and troponin T) are elevated in Ml (ST-segment elevation Ml and non-ST-segment elevation Ml), but normal in chronic stable angina and unstable angina. 

Distinguishing Characteristics of Chronic Stable Angina and Unstable Angina... 

Ischemic Heart Disease/Chronic Stable Angina... 

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