Ischemic Heart Disease and Nitrates

Flashcards about ischemic heart disease and nitrates.

What is ischemic heart disease?

A condition characterized by a mismatch between myocardial oxygen demand and supply.

What are some common causative conditions of ischemic heart disease?

Angina pectoris, coronary artery disease, and coronary syndromes.

What is the primary goal of nitrates in treating ischemic heart disease?

Restoring blood flow and reducing oxygen demand.

Give an example of a long-acting nitrate used for stable angina.

Isosorbide mononitrate.

What shorter acting nitrate may be indicated for acute angina pectoris cases, acute coronary syndromes and hypertension?

Nitroglycerin.

What is nitric oxide?

Vasodilator produced by the endothelium.

What enzyme primarily activates nitrates, converting nitroglycerin into nitrate?

Mitochondrial aldehyde dehydrogenase.

What does nitric oxide activate, and what is the result of this activation?

Increases cyclic guanosine monophosphate (cGMP).

How does an increase in cyclic GMP affect intracellular calcium and smooth muscles?

Reduces intracellular calcium, causing myosin and actin to detach, relaxing smooth muscles.

What effect does nitric oxide have on cardiac preload and end diastolic volume, and what causes this effect?

Venous dilation and increased venous capacity, reducing cardiac preload and lowering end diastolic volume.

How does a lower end diastolic volume affect myocardial workload and oxygen demand?

Lower end diastolic volume results in a reduction of myocardial workload, decreasing oxygen demand.