8.28 THE IMPORTANCE OF METABOLIC DISORDERS IN THE TREATMENT OF STABLE ANGINA
Abstract
Coronary artery disease is a disease of the heart and blood vessels (cardiovascular disease), which also includes stroke, high blood pressure and atherosclerosis.
The main symptoms of coronary heart disease are angina (stable and unstable), myocardial infarction (MI) and sudden coronary death. However, the largest group is made up of angina patients, including those who have already had a heart attack and those who suffer from coronary artery disease.
Therefore, it is no coincidence that real doctors are interested in the correct treatment of patients with angina pectoris and the selection of optimal therapy.
Key Words: Coronary Artery disease, myocardial infarction, angina pectoris.
Purpose of the study: When treating these patients, physicians face two challenges, some of which require different approaches.
Prevention of myocardial infarction and sudden cardiac death and elimination or maximum enhancement of symptoms of the disease (clinical and/or instrumental signs of myocardial ischemia).
In addition, successful treatment of patients with angina requires modification of risk factors that contribute to the development of atherosclerosis, the pathological substrate of coronary heart disease.
Materials and methods: Current thoughts on the pathogenesis of angina pectoris In all forms of coronary heart disease, myocardial ischemia results from an imbalance between oxygen supply and myocardial demand.
In stable angina, myocardial ischemia due to restriction of coronary blood flow leads to severe coronary artery stenosis.
It has long been known that vasodilator and vasoconstrictor stimulation can significantly change the tone of the coronary arteries and “introduce” additional dynamic stenosis into already existing solid stenoses. However, only relatively recently has it become known that the endothelium plays an important role in this process as a regulator of vascular tone, and its dysfunction can occur even before the appearance of atheroma.
It is even known that this is an early stage, during the progression of the atherosclerotic process. The endothelium plays an important role in vascular homeostasis.
It involves the local production of nitric oxide (II) (NO) from L-arginine by endothelial NO synthase.
