It is going to the demand.
Now this is important for us because ultimately
this takes us into the concept and explanation
for management. With management, what might
you want to do? You might want to try to do
something to vasodilate and improve the perfusion
to the heart in terms of supply, or what about
demand? What if the demand is too much? What
if the demand for oxygen by the heart is too
much? What might you want to do with the demand
please as one of your objectives? It is to
make sure that you decrease the demand enough.
What does demand mean to you? The demand side
basically has two major things. Number 1, the heart
rate. So, the faster that the heart then works,
the more energy that it then requires in the
form of what? ATP. How do you form ATP in the
mitochondria? I believe it is called what?
Electron transport chain or oxidative phosphorylation.
And this all begins with the process of what?
Glycolysis and TCA cycle then feeding into your
the ETC, but you must have oxygen there. The
point is now you have too much demand may
be because of increased heart rate or the
pumping. How hard is it pumping? The resistance
or blood pressure is what you are referring
to. Ultimately the tachycardia and high blood
pressure increases the myocardial oxygen demand
that what might you want to do in this patient
when the demand is too much? You do everything
in part to make sure that you slow down. And
so may I ask you something? How much do you
want to decrease your heart rate? It is called
beta-blocker. What might you want to do in
terms of your blood pressure? Try to decrease
it. So these are things that are you going
to be paying attention to as we continue
through our lecture series. What are those modifiable
risk factors? Smoking.
Try to prevent your patient from smoking or
if the patient already started smoking, to
quit the smoking whatever the cessation methodologies
might be. Hypertension, hyperlipidemia, diabetes.