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Old 05-23-2015
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Default Q B blocker for antianginal therapy

If we give B blockers as an anti-anginal therapy, what will happen to end diastolic volume? FA 2014 ed. mentions increased EDV but FA 2015 mentions dec or no . My understanding matches more to the increased EDV. But, since 2015 is new edition, it is more possible that b blocker decreases EDV.If 2015 is correct, can anybody explain how B blocker decrease EDV???Thanks.
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Old 05-23-2015
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Originally Posted by Aumsai View Post
If we give B blockers as an anti-anginal therapy, what will happen to end diastolic volume? FA 2014 ed. mentions increased EDV but FA 2015 mentions dec or no . My understanding matches more to the increased EDV. But, since 2015 is new edition, it is more possible that b blocker decreases EDV.If 2015 is correct, can anybody explain how B blocker decrease EDV???Thanks.

I never really trusted First Aid in my prep -- too many errata get published each yeah. You may want to check them out and see if this is covered as one of them.

The reality of LVEDV in this context is slightly complex. Depending on the situation, you could see unchanged or increased EDV post-BB. It all comes back to the mechanism.

BB treat angina by lowering myocardial oxygen demand and improving coronary perfusion. They do this by slowing the HR and slightly by a negative inotropic effect, but their effect on HR is key. It does this primarily by slowing conduction through the AV node, among other things. What this means is you spend a longer portion of each cardiac cycle in diastole, the time when the coronaries are perfused. So fewer beats + longer diastole = lower O2 demand + better perfusion.

With the longer diastole, you would presumably see some increased EDV. However, this would depend on the etiology of the angina and the current cardiac status of the patient. If the patient is tachycardic or close to it, then a BB would probably increase EDV slightly; if not, then it may not have any effect.

You really need to assess the patient and determine why you believe he is having angina and then think mechanistically through how you would expect your treatment to fix it.
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Old 05-24-2015
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Got it.Thanks young doc .
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