Coronary ischemia

Nicardipine hydrochloride 5-15 mg/hour IV 5-10 minutes 15-30 minutes, may exceed 4 hours Tachycardia, headache, flushing, local phlebitis Most hypertensive emergencies except acute heart failure use with caution with coronary ischemia... 

Nitroglycerin 5-1 00 mcg/kg/minute as IV infusion 2-5 minutes 5-1 0 minutes Headache, vomiting, methemoglobinemia, tolerance with prolonged use Coronary ischemia... 

Referred pain is felt in a part of the body different from the actual tissue causing the pain. Typically, the pain is initiated in a visceral organ or tissue and referred to an area of the body surface. Classic examples of referred pain include headache and angina. Interestingly, the brain does not contain nociceptors therefore, pain perceived as a headache originates in other tissues, such as the eyes sinuses muscles of the head and neck and meninges. Angina, or chest pain, is caused by coronary ischemia. It may be accompanied by pain referred to the neck, left shoulder, and left arm. 

Common precipitating factors that may cause a previously compensated patient to decompensate include noncompliance with diet or drug therapy, coronary ischemia, inappropriate medication use, cardiac events (e.g., MI, atrial fibrillation), pulmonary infections, and anemia. 

Vasopressin, alone or in combination with nitroglycerin, can no longer be recommended as first-line therapy for the management of variceal hemorrhage. Vasopressin causes nonselective vasoconstriction and can result in hypertension, severe headaches, coronary ischemia, myocardial infarction, and arrhythmias. 

Thus, people who are prone to coronary ischemia or carotid occlusion may be at risk for heart attack or ischemic stroke when taking these COX-2 selective... 

Brady WJ, Jr, Harrigan RA. Diagnosis and management of bradycardia and atrioventricular block associated with acute coronary ischemia. Emerg Med Clin North Am. 2001 19 371-384. 

In pigs, high dose of VEGF delivered extraluminally after coronary occlusion caused higher blood flow in the ischemic territory (31). In a canine model of chronic coronary ischemia, VEGF showed enhanced collateral vessel density and blood flow when delivered as a local infusion, although not when administered systemically (32). 

Vinca alkaloid-associated myocardial infarction, angina pectoris, and transient electrocardiographic changes related to coronary ischemia are limited to case reports (22-24). In addition, patients with these adverse effects... 

M. N. Sack, and D. M. Yellon, Insulin Therapy as an Adjunct to Reperfusion After Acute Coronary Ischemia, A Proposed Direct Myocardial Cell Survival Effect Independent of Metabolic Modulation, J Am Coll Cardiol 41,1404-07 (2003). 

M.N. Sack and D. Yellon, Insulin therapy as an adjunct to reperfusion after acute coronary ischemia, J. Am. Coll. Cardiol. 41, 1404-1407 (2003). 

The lowest dosage of drug capable of normalizing the T wave amplitude in 50% of the test animals, or the percentage decrease in the T wave produced by different dosages of the drugs, was claimed to be more sensitive for drug evaluation than results obtained by Inhibition of pituitrin induced vasoconstriction. In all attempts to produce experimental coronary ischemia, the question remains as to how closely the experimental procedure resembles the clinical situation. 

One aspect of hypoxia which has and still is receiving much attention, because of its potential therapeutic value, is coronary ischemia. Smith and Lawson (S21) reported that the administration of oxygen at 2 ata protected dogs against ventricular fibrillation during acute interruption of the main left circumflex coronary artery. Although the ligation resulted in ischemia to 40% of the ventricular muscle mass, the administration of OHP was able to maintain more of these hypoxic cells in a viable state. In essence these results were confirmed by Meijne et al. (MIO), Petropoulos (P12),... 

Other complications of vasospasm include coronary ischemia and myocardial infarction, abdominal angina and bowel infarction, renal infarction and failure, visual disturbances and blindness, and stroke. Psychosis, seizures, and coma occur rarely. 

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