Question

Mrs Spironakis was an active senior who played pennant grade tennis. Recently she found she was out of breath more frequently and feeling a tightness in the chest that she had not really experienced before. During her last game she fell to the ground holding her chest complaining of pain. One of her close friends suggested she see a doctor to determine whether she may be suffering from angina. A. What is angina and explain why you think she may suffer from this, particularly when playing tennis. Her doctor sent her to a cardiologist who did indeed diagnose angina and prescribed Mrs Spironakis a novel new drug that acted on acetylcholine receptors on the heart but specifically resulted in only vasodilating coronary blood vessels. B. Discuss the intracellular mechanisms that are likely to underpin the actions of this novel drug. Julie S, a close friend of Mrs Spironakis, has high blood pressure and she is currently treated with different classes of drugs including, verapamil, hydrochlorothiazide and enalapril. Her blood pressure, however, is poorly controlled. Her GP asked if she would like to participate in a drug trial for a new antihypertensive agent. The new drug inhibits the actions of noradrenaline selectively on the heart and vascular smooth muscle. C. Explain how this new drug can lower blood pressure.

Answer 1

Angina is chest pain or pressure that occurs when heart muscle cells do not receive enough blood flow. Mrs. Spironakis may be suffering from angina due to her symptoms and the physical activity of playing tennis. The novel drug prescribed to her relaxes her coronary blood vessels, increasing blood flow and relieving her angina symptoms. The new antihypertensive drug being offered to Julie S inhibits the actions of noradrenaline on the heart and blood vessels, leading to vasodilation and a decrease in blood pressure.

Step-by-step explanation:

Angina is chest pain or pressure that occurs when heart muscle cells do not receive adequate blood flow and become starved of oxygen. It is usually caused by atherosclerosis, which is the buildup of plaque in the coronary arteries. In the case of Mrs. Spironakis, her symptoms of chest tightness, shortness of breath, and pain during physical activity such as playing tennis suggest that she may be suffering from angina. The stress and exertion of playing tennis can increase the demand for oxygen by the heart, making the symptoms more likely to occur in individuals with angina.

The novel drug prescribed by Mrs. Spironakis' cardiologist acts on acetylcholine receptors on the heart and specifically results in vasodilation of coronary blood vessels. Acetylcholine is a neurotransmitter that has a constricting effect on these blood vessels. By inhibiting the actions of acetylcholine on the heart, the drug allows for increased blood flow to the heart, relieving the symptoms of angina.

The new antihypertensive drug being offered to Julie S inhibits the actions of noradrenaline selectively on the heart and vascular smooth muscle. Noradrenaline is a neurotransmitter that constricts blood vessels and increases blood pressure. By inhibiting the actions of noradrenaline, the drug can relax the smooth muscle in blood vessels, leading to vasodilation and a decrease in blood pressure.