A patient of prinzmetal's angina is staed on isosorbide mononitrate. What is the mechanism of action of nitrates in this condition?
Prinzmetal's angina is due to spasm of main coronary aery. Treatment is by dilatation of coronary aery. Endothelium normally generates NO, but here we are giving nitrates for generation of NO. Mechanism of action of nitrates: Preload reduction >> Afterload reduction Redistribution of coronary flow in the aerial tree action may cause orable redistribution of blood flow to ischaemic areas in angina patients.
Reduced cardiac contractility
Increased left ventricular end diastolic volume
Decreased diastolic perfusion pressure
Endothelium independent coronary vasodilation
Hematology and CVS