Document Detail

Calcium antagonists for angina pectoris.
MedLine Citation:
PMID:  2897819     Owner:  NLM     Status:  MEDLINE    
Angina presents itself to us as a continuous spectrum of ischemic syndromes. The disease is multifactorial, and within the same patient different pathophysiological mechanisms may occur at different times and in succession. Several factors may be causative at a particular moment of the disease process and the very next moment a different mechanism may prevail or spontaneous improvement may occur. Among these are stable atheroma with episodic increased vasomotor tone, fissured plaques with intraluminal and/or intraintimal thrombus, thrombocyte aggregation in greater than 70% intraluminal narrowing from ulcerated plaques, as well as frank spasm of vessels without major atherosclerosis. Consequently, there will never be one therapy for every case of (un)stable angina nor will there ever be a best therapy for all. Rather, a stepped approach appears the most likely to be successful. This begins with bed rest and requires vasodilator therapy with nitrates and/or Ca2+ antagonists and beta blockade. If this triple therapy does not "cool" the symptoms within 6-12 hours, semiurgent arteriography is indicated. Depending on the pathophysiology found, thrombolytic therapy with streptokinase or tissue plasminogen activator, percutaneous transluminal coronary angioplasty (PTCA), or coronary artery bypass grafting (CABG) must be carried out early. Heparin in the short term and aspirin in the long term protect best against late complications. The moment is now here when infarction or death after an attack of angina pectoris should be rare.
P G Hugenholtz
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Annals of the New York Academy of Sciences     Volume:  522     ISSN:  0077-8923     ISO Abbreviation:  Ann. N. Y. Acad. Sci.     Publication Date:  1988  
Date Detail:
Created Date:  1988-06-29     Completed Date:  1988-06-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7506858     Medline TA:  Ann N Y Acad Sci     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  565-83     Citation Subset:  IM    
University Hospital, Erasmus University, Rotterdam, The Netherlands.
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MeSH Terms
Adrenergic beta-Antagonists / therapeutic use
Angina Pectoris / drug therapy*,  physiopathology
Anticoagulants / therapeutic use
Aspirin / therapeutic use
Calcium Channel Blockers / pharmacology,  therapeutic use*
Nitroglycerin / therapeutic use
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Anticoagulants; 0/Calcium Channel Blockers; 50-78-2/Aspirin; 55-63-0/Nitroglycerin

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