Atherosclerosis: Demand

by Carlo Raj, MD

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    00:00 Let's go into the demand.

    00:02 Now, this is important for us because ultimately, this takes us into the concept and the explanation for management.

    00:10 With management, what might you wanna do? You might wanna try to do something to vasodilate and improve the perfusion to the heart in terms of supply.

    00:18 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 wanna do with the demand, please as one of your objectives? It's to make sure that you decrease the demand.

    00:30 Now, what does demand mean to you? Well, the demand side basically has two major things.

    00:35 Number one, the heart rate.

    00:37 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's called, what? Electron transport chain or oxidative phosphorylation, good.

    00:52 And this all begins with the process of, what? Glycolysis, NTC cycle and then feeding into your ETC.

    00:59 But you must have oxygen there, correct? And so the point is, now you have too much demand maybe because of increased heart rate or the pumping.

    01:07 How hard is it pumping? The resistance or blood pressure is what you're referring to.

    01:13 So ultimately the tachycardia and the high blood pressure increases what? The myocardial oxygen demand.

    01:20 Then what might you wanna do in this patient when the demand is too much? You do everything in your power to make sure that you slow it down.

    01:26 And so may I ask you something? How might you wanna decrease your heart rate? It's called beta blocker. What might you wanna do in terms of your blood pressure? Try to decrease it. So these are things that you're going to be paying attention to as we continue through our lecture series.

    01:39 What are those modifiable risk factors? Smoking. Try to prevent your patient from smoking.

    01:45 Or if the patient already started smoking to quit the smoking whatever the association methodologies might be.

    01:52 Hypertension, hyperlipidemia, diabetes. Metabolic syndrome –

    About the Lecture

    The lecture Atherosclerosis: Demand by Carlo Raj, MD is from the course Atherosclerosis: Basic Principles with Carlo Raj.

    Included Quiz Questions

    1. Beta blockers
    2. Dihydropyridine calcium channel blockers
    3. Diuretics
    4. ACE inhibitors
    5. Alpha blockers

    Author of lecture Atherosclerosis: Demand

     Carlo Raj, MD

    Carlo Raj, MD

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