PHAR1101 Lecture Notes - Lecture 12: Aurel Stein, Coronary Artery Disease, Atrial Fibrillation
Nitroglycerin
Common diseases affecting the cardiovascular system:
- Angina
- Arrhythmia
- Atrial fibrillation
- Hypertension
- Atherosclerosis
- Myocardial infarction
- Congestive heart failure
Ischaemic heart disease (angina, heart attacks and blocked arteries) was leading cause of death in 2014
Australia.
- 1/7 male
- 1/8 female
Cerebrovascular disease (e.g. stroke) was 3rd major cause of death.
Angina:
What is it?
- Spasmodic bouts of intense pain in upper chest – often to left arm
- Sense of suffocation and impending death
- Can be stable (predictable frequency, provoked by exercise, excitement etc)
or unstable (unpredictable without provocation).
What causes it?
When low blood flow (myocardial ischemia) limits O2 delivery to heart muscle
during exertion
- Atherosclerotic narrowing of coronary artery is main cause (i.e. block in blood vessels
which supply heart)
Involves fatty deposits (plaques) in blood vessel (atherosclerosis).
Nitre – angina remedy in ancient China?
1907 – Central Asia, old manuscripts found
- Many documents acquired by Aurel Stein, including 19 medical
- One text describes use of nitre to treat chest pains.
- Recommends careful retention under tongue
find more resources at oneclass.com
find more resources at oneclass.com
Invention of nitroglycerin:
Ascanio Sobrero: Chemistry professor in Italy.
Invented nitroglycerin using glycerol and mineral acids (chill reaction)
Considered it too dangerous to be of practical use
Alfred Nobel: family sold nitroglycerin to mining companies
- Explosion at Stockholm plant killed his brother and 4 others
- In next 8 years killed lots more
Found nitroglycerin is stable if blended with porous silica gel
- Invented patented detonator which made a fortune
Monday disease:
Munitions factory workers exposed to large quantities of nitroglycerin
- Strong headaches, facial flushing on return to work after weekend break
- From persistent vasodilation during working week
Some workers solved situation by wearing work clothes on the weekend
William Murrell: Medicine trained physician
Aware of conflicting literature reports concerning nitroglycerin and headaches
- Aware of use of amyl nitrate in angina by Lauder Brunton.
Got a 1% solution – put tiny bit on tongue
- Pulse increased rapidly
First trials on 35 healthy individuals
- Variability in response:
- Used early BP monitoring device to confirm beneficial effects in 3 angina patients
Nitroglycerin in modern medicine;
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Ischaemic heart disease (angina, heart attacks and blocked arteries) was leading cause of death in 2014. Cerebrovascular disease (e. g. stroke) was 3rd major cause of death. Spasmodic bouts of intense pain in upper chest often to left arm. Can be stable (predictable frequency, provoked by exercise, excitement etc) or unstable (unpredictable without provocation). When low blood flow (myocardial ischemia) limits o2 delivery to heart muscle during exertion. Atherosclerotic narrowing of coronary artery is main cause (i. e. block in blood vessels which supply heart) Involves fatty deposits (plaques) in blood vessel (atherosclerosis). Many documents acquired by aurel stein, including 19 medical. One text describes use of nitre to treat chest pains. Invented nitroglycerin using glycerol and mineral acids (chill reaction) Considered it too dangerous to be of practical use. Alfred nobel: family sold nitroglycerin to mining companies. Explosion at stockholm plant killed his brother and 4 others. Found nitroglycerin is stable if blended with porous silica gel.
