A 72-year-old man with a 3-year history of coronary artery disease presents with complaints of chest pain that occurs predictably when climbing stairs or walking briskly, but resolves within 5 minutes of rest. He denies chest pain at rest or during sleep. His vital signs are: BP 138/82 mm Hg, HR 96/min, RR 16/min. Physical examination is unremarkable. Resting 12-lead ECG shows no acute changes. Transthoracic echocardiogram demonstrates preserved left ventricular ejection fraction with no wall motion abnormalities. The patient is currently not taking any cardiac medications. Which of the following drug classes would be most effective at reducing the frequency and severity of his anginal episodes?
- A)Alpha-1 adrenergic antagonist
- B)Angiotensin-converting enzyme inhibitor
- C)Beta-1 adrenergic antagonistGABARITO
- D)Calcium channel blocker with negative inotropic effects
- E)Phosphodiesterase-5 inhibitor
Explicação
Beta-1 adrenergic antagonists (e.g., metoprolol, atenolol) are first-line agents for stable angina. By blocking cardiac beta-1 receptors, they decrease heart rate and myocardial contractility, which reduces myocardial oxygen demand—the primary mechanism of sym... Ver explicação completa e trilha adaptativa →