MEDICINE FOR CHEST PAIN, सीने में दर्द होने के कारण लक्षण और इलाज, ANGINA PECTORIS, CAUSES TREATMENT
Channel: PHARMAROCKS THE WAY OF SUCCESS
Date: 2021-01-21

MEDICINE FOR CHEST PAIN, 
सीने में दर्द होने के कारण लक्षण और इलाज, 
सीने में दर्द होना

ANGINA PECTORIS 
Angina pectoris is the medical term for chest pain or discomfort due to coronary heart disease. 
It occurs when the heart muscle doesn't get as much blood as it needs. 
This usually happens because one or more of the heart's arteries is narrowed or blocked
It is also called ischemia.

ANGINA PECTORIS 
Angina is a symptom of coronary artery disease.
Angina is the chest pain that occurs due to imbalance between oxygen supply and demand.
In angina, there is a fixed atherosclerotic narrowing of the coronary arteries

HOW CHEST PAIN OCCURS?
1. Imbalance between oxygen supply and demand to heart
2. Blood flow to endocardium occurs mainly during diastole.
3. At rest, the patient does not develop pain because demand is also less which can be met even with reduced flow
4. However, during exercise or emotional stimuli, myocardial oxygen requirement increases that result in anginal pain (because blood supply is fixed and cannot be increased).
5. Two major strategies for the treatment and prevention of angina are to decrease the oxygen requirement or to increase the blood supply to the ischemic region.

ANGINA PECTORIS CAUSES
Narrowing of blood vessels who supply blood to heart
Atherosclerosis means buildup of fats, cholesterol and other substances in and on your artery walls (plaque), which can restrict blood flow.
Coronary artery disease in which narrowing or blockage of coronary arteries

ANGINA PECTORIS CAUSES
Lack of exercise & Sedentary lifestyle
Unhealthy diet increase deposit of fat or cholesterol in the walls of artery and narrow the blood vessels

ANGINA PECTORIS SYMPTOMS
Chest pain or discomfort, often described as squeezing pressure, fullness, tightness, or a heavy weight in the centre of the chest
Pain or discomfort in the arms, neck, jaw, shoulder or back
Pain similar to indigestion or heartburn
Shortness of breath and tiredness
Nausea, sweating, and dizziness. 

ANGINA PECTORIS DIAGNOSIS
Electrocardiogram (ECG)
Exercise stress test
Echocardiogram
Chest x-ray
Coronary angiography
Computerised tomography (CT) scan
Magnetic resonance imaging (MRI) 

ANGINA PECTORIS TREATMENT
FOLLOWING ARE THE MEDICATIONS USE IN ANGINA
Nitrates
Aspirin
Beta blockers
Calcium channel blockers
Blood pressure-lowering medications
Ranolazine (Ranexa)
Statins

NITRATES FOR ANGINA PECTORIS 
Following are important compounds in this category.
Glyceryl trinitrate  (nitroglycerine)
Isosorbide dinitrate  (IDN)
Isosorbide mononitrate (IMN)
Erythrityl trinitrate
Pentaerythritol tetranitrate
Amyl nitrite  

CALCIUM CHANNEL BLOCKERS
Verapamil, diltiazem and long acting DHPs (dihydropyridines) can be used in angina. 
Short acting DHPs like nifedipine should be avoided because these can accentuate the symptoms of angina by causing tachycardia.

BETA BLOCKERS FOR ANGINA PECTORIS 
Propranolol, atenolol & metoprolol
By slowing the heart rate, beta blockers reduce the oxygen demand of the heart and reduce the frequency of angina attacks in patient with angina pectoris 
Guidelines recommend beta blockers as first-line treatment in patients with angina either on their own or in combination with a calcium channel blocker.

POTASSIUM CHANNEL OPENERS
Nicorandil is the agent that causes coronary dilation by activating myocardial ATP sensitive K+ channels. 
It works by relaxing and widening our blood vessels, which increases the supply of blood and oxygen to our heart. 
This helps reduce the chest pain angina causes.

RANOLAZINE
By reducing the flow of calcium into the cells, ranolazine is thought to help the heart to relax, improving blood flow to the heart muscle and relieving the symptoms of angina pectoris.

NEW DRUGS FOR ANGINA PECTORIS 
Ivabradine is a new drug for angina. 
It is known as  bradycardiac agent (as it decreases heart rate without affecting the conduction or contractility)
Fasudil is a selective Rho A/Rho kinase (ROCK) inhibitor. 
ROCK is an enzyme that plays important role in vasoconstriction and cardiac remodeling.

ANGINA PECTORIS, CAUSES TREATMENT

#CHEST_PAIN
#सीने_में_दर्द
#ANGINA_PECTORIS




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