Ischemic Heart Disease

Ischemic Heart Disease 1. 2.

3.

Stable angina Unstable angina/ non-ST elevation MI Acute myocardial infarction

Coronary Arterial Disease

Stable Plaque

Unstable Plaque

Disrupted Plaque

From Eugene Braunwald, 5th Edi, Heart Disease, A Textbook of Cardiovascular Medicine.

治療心絞痛藥物

1. 2. 3.

Beta-blocking agents Nitrates Calcium channel blockers

Beta-blocking agents

From Eugene Braunwald, 5th Edi, Heart Disease, A Textbook of Cardiovascular Medicine.

Nitrates „

Vasodilatory effects: – coronary and peripheral

Reduced oxygen demand „ Vascular receptors: „

– formation of NO

From Eugene Braunwald, 5th Edi, Heart Disease, A Textbook of Cardiovascular Medicine.

Calcium Channel Blockers

Pharmacology Effect on CCB Diltiazem Verapamil

DHP

Heart rate

z

z

yQ

Myocardial contractility Nodal conduction Peripheral vasodilation

z

zz

zQ

z

zz

Q

y

y

yy

yincrease

zdecrease

Qno change

Dipyridamole ( Persantin ) 1.

2.

3. 4.

Coronary vasodilation: inhibition of adenosine transport Inhibition of platelet adhesion to damaged vessels Inhibition of platelet aggregation Potentiate the antiaggregatoy effect of prostacyclin