Tutorial - Angina

What major coronary vessels supply blood flow to the myocardium? click here
What factors determine coronary vascular tone and therefore coronary blood flow? click here
How and where is nitric oxide formed in a coronary vessel and what is it physiological role? click here
What is active hyperemia and what mechanisms are responsible for this phenomenon? click here
How do sympathetic and parasympathetic activation of the heart alter coronary blood flow? click here
How do mechanical forces during the cardiac cycle alter coronary blood flow? click here
What determines oxygen supply (delivery) to the myocardium? click here
What determines the degree of oxygen extraction from the coronary blood as it passes through the heart? click here
How is myocardial oxygen demand (consumption) determined? click here
What is the myocardial oxygen supply/demand ratio and what factors alter this ratio? click here
Why does a decrease in the myocardial oxygen supply/demand ratio precipitate angina? click here
How does the oxygen supply/demand ratio determine the level of myocardial tissue oxygenation? click here
Define ischemia and hypoxia. click here
How does myocardial hypoxia alter electrical click here and mechanical function click here?
What is a critical coronary stenosis and why does it limit coronary vasodilator reserve? click here
What is coronary vascular steal and under what conditions can it occur? click here
Define each of the following and state the underlying cause: chronic stable angina, Prinzmetal's (variant) angina, and unstable angina. click here

Antianginal Drugs

How do antianginal drugs affect myocardial oxygen supply and demand, and how do these actions reduce chest pain? click here
Which antianginal drugs are used to treat the following types of angina, and what actions of these drugs make them suitable for a particular form of angina? click here
    - chronic stable angina
    - Printzmetal's variant angina
    - unstable angina
What are the mechanisms by which organic nitrate nitrodilator drugs dilate veins and how does this relieve angina? click here
What is drug tolerance and how does tolerance to organic nitrates affect dosing? click here
What are common side-effects to organic nitrates? click here
Which calcium-channels blockers are approved for angina and how do these drugs reduce anginal pain? click here
What preexisting conditions in patients can be made worse by administering calcium-channel blockers? click here
Why should calcium-channel blockers not be given with beta-blockers? click here
Why are beta-blockers useful antianginal drugs? click here
What are the mechanisms by which beta-blockers reduce heart rate and contractility (inotropy)? click here
Define the following characteristics for beta-blockers: click here
    - selective vs. non-selective beta-blockade
    - intrinsic sympathomimetic activity
    - membrane stabilizing activity
What are some common side-effects and contraindications for beta-blockers? click here

Revised 08/31/06

DISCLAIMER: These materials are for educational purposes only, and are not a source of medical decision-making advice.