Introduction – Heart Failure and Angina Management

00:01 Welcome to pharmacology by Lecturio. I'm Dr. Pravin J.Shukle and we are going to be talking about heart failure management and angina management. Let's take a look at this diagram.

00:13 Angina literally means pain in the chest. Typical symptoms of angina are caused by narrowing of blood vessels. Be very aware that angina doesn't necessarily mean that the blood vessel is completely blocked off. It just means that the blood flow is restricted through a process of atherosclerosis. Heart failure is when the heart is not pumping enough blood to do its job.

00:38 You can have diastolic heart failure and systolic heart failure. Diastolic heart failure is the first stage of generalized heart failure. What people don't realize about heart failure and how the heart works is that the energy consuming cycle of the heart is actually when it opens up. That's a hard concept to understand. I want you to think about a bow and arrow.

01:02 We put energy into the bow as we pull back on it, and then at the right moment we let go of the string and it pushes the arrow forward. The heart works the same way. We put energy into the heart as it opens up it waits for a signal and then it contracts. Almost like an elastic recoil. Diastolic dysfunction means that we don't have enough strength to open up the arrow either quickly enough or enough in terms of volume. Angina specifically is a reduced blood flow because of narrowing of the blood vessels of the heart. We put these two diseases together because the treatment of both conditions often overlap.

01:46 Let's start with drugs used in angina. Angina can be treated with vasodilators. These vasodilators can be nitrates or calcium channel blockers like verapamil. There are many types of nitric based treatments.

02:03 There are the short duration nitrates, the intermediate duration nitrates and the long duration nitrates.

02:10 In terms of treating angina we do talk about vasodilator activity of calcium channel blockers.

02:16 But there is another side to calcium channel blockers. They are also cardiac depressants.

02:21 So they slow down the heart rate and reduce the oxygen demand that the heart is asking for.

02:28 The other cardiac depressants are beta blockers. We have other drugs that are used in angina as well.

02:36 Those are metabolism modifiers and other rate inhibitors.

02:41 So these are the drugs that are used in angina.