IHD

Question 1

Three types of IHD

Answer 1

1. Stable
2. Vasospastic
3. Prinzmetal

Question 2

Main concept that explains Pathogenesis of IHD

Answer 2

1. Insufficient O2 supply:
   - Coronary blood flow
   - O2 extraction
   - O2 saturation
2. Increased O2 demand:
   - HR
   - Contractility
   - Wall tension (afterload)

Question 3

Assuming no C/I and other comorbidities, what are the initial therapy for a typical SIHD patient?

Answer 3

1. BB: First line
2. Short-acting Nitrate
3. Aspirin

Question 4

A patient with stable IHD is already on max bisoprolol dose. However, patient is still symptomatic. What is the next drug to add?

Answer 4

CCB

• E.g. Nifedipine LA
• E.g. Amlodipine
• E.g. Diltiazem

Question 5

A patient is unable to tolerate SE of Carvedilol. What is the next drug in line? Patient is currently not on other drugs

Answer 5

CCB/LAN

Question 6

Treatment is to be initiated for a patient with CKD for SIHD. What are the drugs to be initiated? Assume no allergies

Answer 6

1. BB
2. ACEI (CKD compelling indications)
3. Aspirin
4. Short-acting nitrates