00:01
Let us take a look at the management of your
patient who has stable angina, acute coronary
syndrome. Let us go back to quickly
our discussion. If it is stable, exertion,
angina, pain. If it is acute coronary
syndrome, then the plaque has gotten so big
that the pain is going to be at rest. Myocardial
infarction, acute, we've walked through in great detail
in our previous lectures. What is the two
immediate goals? Let us go back to the physiology
that we talked about where we are addressing
the demand and we are addressing the supply.
00:36
What do you want to do? If you know that your
heart is compromised due to whatever reason,
in this case the atherosclerosis, then would
that make sense to try to decrease the demand
of the heart. So, therefore, what kind of
receptor does the heart have in which its
activity is pretty much controlled or influenced?
Beta-1 receptor. When I try to control the
beta receptors, why not administer some calcium
channel blockers? Those are the thing that you
pay attention, now be careful though because
if you administer too much or if you have
your patient going into massive MI, then the
heart has no chance of recovering, you’re
going to kill your patient so be careful when
you are giving such drugs. Or what about the
supply? We know that the supply has already
been compromised when I try to get in there
and try to remove that clot and by doing so,
aren’t you addressing both goals?