Chronic stable angina, associated with inadequate blood flow to meet the metabolic demands of the myocardium, is caused by:
A) Fixed coronary obstruction
B) Increased collateral circulation
C) Intermittent vessel vasospasms
D) Excessive endothelial relaxing factors
Ans: A
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Chronic stable angina is caused by fixed coronary obstruction that produces an imbalance between coronary blood flow and the metabolic demands of the myocardium. Endothelial relaxing factors relax the smooth muscle in the vessel wall and allow increased blood flow; treatment for chronic stable angina is with a vasodilating agent, such as nitroglycerine, that relaxes the vessels and enhances coronary blood flow. Intermittent vessel vasospasms, in conjunction with coronary artery stenosis, cause the vasospastic type of angina. Increased formation of collateral vessels is a compensatory response that allows adequate blood circulation to tissues distal to an obstruction.
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