Chapter 23, Problem 1O

Summary Introduction

To describe:

The pathophysiology of myocardial ischemia and subsequent occurrence of angina.

Concept introduction:

The heart is the unique organ that pumps oxygenated and receives deoxygenated blood from other organs. There are various malfunctions occur that damage the heart like low oxygen level causes angina pectoris, damage of heart cells leads to ischemia later to ischemic heart disease, deposits of fatty materials in the artery leads to Coronary Heart Disease (CAD), acute CAD leads to heart attack. The angina pectoris is classified into three classical types of chest pain they are chronic stable angina, unstable angina, and vasospastic angina. The nitrates and nitrites, Calcium Channel Blockers (CCBs), and the beta blockers are the classical three classes of drug that used as anti-angina drugs.

Explanation of Solution

The progression of acute coronary artery disease leads to myocardial infarction (MI) or heart attack. The heart switches to anaerobic metabolism when energy supply to the heart is less, the anaerobic metabolism results in accumulation of lactic acids that gives pain in the heart as well as the surrounding part are called as angina. There are three classical types of chest pain like chronic stable angina (effort angina), unstable angina, and vasospastic angina. The effort angina is caused due to stress in the arteries (atherosclerosis). The early progressive stage of coronary artery disease is unstable angina and the crescendo is another type of unstable angina and it is distinguished by severe and frequent pain. The patients suffering from vasospastic angina are subjected to chest pain even when they are at rest. Since the calcium present in the blood will constrict the muscles and smooth of the arteries, the vasoconstriction of the arteries gives chest pain.

Conclusion

The MI happen when the blood flows from the coronary artery to the myocardium is completely blocked, it can lead to death if not attended immediately.