# 11 Stable Angina ## Symptoms [\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Cardiology/stable%20angina%20symptoms,%20typical%20case,%20diagnosis%20how/README.md).. ![](https://f001.backblazeb2.com/file/wikiFiles/9AT1j2u.jpg) * stable, no thrombus, not ruptured * exercise: more O2 demand, not enough supply [\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Cardiology/stable%20angina%20treatment%20strategy/README.md).. ![](https://f001.backblazeb2.com/file/wikiFiles/ujQfLHZ.jpg) ![](https://f001.backblazeb2.com/file/wikiFiles/3DFjPqm.jpg) * coronary arteries supplied in diastole ![](https://f001.backblazeb2.com/file/wikiFiles/QXhHiPX.jpg) ![](https://f001.backblazeb2.com/file/wikiFiles/GYwO6YR.jpg) [\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Cardiology/ignore/README.md).. ![](https://f001.backblazeb2.com/file/wikiFiles/t3P1Nl9.jpg) ![](https://f001.backblazeb2.com/file/wikiFiles/iGO5EB3.jpg) ## Angina Physiology [\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Cardiology/angina%20and%20diastole,%20HR,%20LVEDV%20changes.%20What%20are%20ejection%20time%20and%20MVO2).. ![](https://f001.backblazeb2.com/file/wikiFiles/FHBQYEz.jpg) ![](https://f001.backblazeb2.com/file/wikiFiles/QnsmBZv.jpg) * faster HR, more O2 demand, less O2 delivered ![](https://f001.backblazeb2.com/file/wikiFiles/YSv7AMR.jpg) ![](https://f001.backblazeb2.com/file/wikiFiles/qt5Hfr3.jpg) ## Treatment [\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Cardiology/nitrates%20MOA,%20SE/README.md).. ![](https://f001.backblazeb2.com/file/wikiFiles/qbpM0K6.jpg) * less O2 demand ![](https://f001.backblazeb2.com/file/wikiFiles/nKjeO4y.jpg) ![](https://f001.backblazeb2.com/file/wikiFiles/A322r23.jpg) ![](https://f001.backblazeb2.com/file/wikiFiles/Zvfov3z.jpg) ![](https://f001.backblazeb2.com/file/wikiFiles/YpoAsaM.jpg) ![](https://f001.backblazeb2.com/file/wikiFiles/spbKTNK.jpg) [\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Cardiology/BB%20moa%20in%20angina/README.md).. ![](https://f001.backblazeb2.com/file/wikiFiles/Z0jzLAB.jpg) * partial: can worsen angina symptoms ![](https://f001.backblazeb2.com/file/wikiFiles/H0Yoq4n.jpg) * Agonizing plastic bugle: acebutolol (a selective beta-1 antagonist with partial agonist activity) * Agonizing pin: pindolol (a nonselective beta blocker with partial agonist activity) * Popping failing heart: beta blockers with partial agonist activity (e.g. pindolol, acebutolol) should be avoided in patients with heart failure or a history of MI [\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Cardiology/CCB%20MOA%20in%20angina,%20SE/README.md).. ![](https://f001.backblazeb2.com/file/wikiFiles/kDzq66Z.jpg) ![](https://f001.backblazeb2.com/file/wikiFiles/3CuYZFr.jpg) ![](https://f001.backblazeb2.com/file/wikiFiles/wC52lZU.jpg) * negative ionotropic effects can cause systolic dysfunction: acute HF ![](https://f001.backblazeb2.com/file/wikiFiles/LGVL6Nf.jpg) * Calci yum: CCB * L-shaped handle: calcium channel blockers target voltage gated L-type calcium channels * Dairy: dihydropyridines * Non-dairy: nondihydropyridines * Smooth muscle tile: dihydropyridines block L-type calcium channels in smooth muscle * Cardiac muscle tile: non-dihydropyridines block L-type calcium channels in cardiac muscle * Dippin' station: -dipine suffix of dihydropyridines (e.g. nifedipine, amlodipine, nicardipine) * Dilated dairy nozzle: dihydropyridines cause vasodilation * Dilated coronary crown: dihydropyridines (e.g. amlodipine, felodipine) dilate coronary arteries * Reduced load: dihydropyridines reduce afterload * Weak kid at the non-dairy: non-dihydropyridines decrease cardiac contractility * Music notes: non-dihydropyridines decrease activity at the SA and AV nodes * Low dangling heart watch: inhibition of the SA node by non-dihydropyridines causes bradycardia * Discarded oxygen: non-dihydropyridines decrease myocardial oxygen demand * Knife cutting heart: nifedipine can exacerbate myocardial ischemia due to reflex tachycardia - avoid in patients with unstable angina or MI (shorter acting, higher SE) * Failing heart balloon locked out of store: CCBs can worsen heart failure (increased sympathetic activity and decreased contractility) [\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Cardiology/antianginal%20therapy%20overview%20drugs%20and%20SE/README.md).. ![](https://f001.backblazeb2.com/file/wikiFiles/pCRiiuX.jpg) ![](https://f001.backblazeb2.com/file/wikiFiles/QQusKtX.jpg) ![](https://f001.backblazeb2.com/file/wikiFiles/3DFjPqm.jpg) * coronary arteries supplied in diastole ## Prinzmetal [\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Cardiology/prinzmetal%20angina%20EKG,%20pathogenesis,%20symptoms,%20treatment,%20diagnosis/README.md).. ![](https://f001.backblazeb2.com/file/wikiFiles/HXTYcOI.jpg) ![](https://f001.backblazeb2.com/file/wikiFiles/2HaUL8F.jpg) * ergonovine: alpha agonist ## Coronary Steal [\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Cardiology/what%20is%20coronary%20steal,%20useful%20how/README.md).. ![](https://f001.backblazeb2.com/file/wikiFiles/MI9QpYn.jpg) ![](https://f001.backblazeb2.com/file/wikiFiles/18AtMaD.jpg) * pts on stress tests: give vasodilators that preferentially dilate healthy territories > coronary steal > can be picked up on tracers (usually won't precipitate EKG/symptoms changes) ![](https://f001.backblazeb2.com/file/wikiFiles/hQDIxnA.jpg) * Don’t phoster disinterest: phosphodiesterase inhibitors (e.g. dipyridamole, cilostazol) * Phosphodiesterase inhibitors increase cAMP, impairing platelet function * Two pyramids: dipyridamole (an antiplatelet phosphodiesterase inhibitor) --- # Agent Instructions: Querying This Documentation If you need additional information that is not directly available in this page, you can query the documentation dynamically by asking a question. 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