A 58 year-old man has been in progressive coronary insufficiency for at least five years, with angina of effort and recent early signs of left ventricular failure.
Cardiac catherization revealed atherosclerotic obstruction of both the left anterior descending and circumflex arteries. Coronary artery bypass graft (CABG) operation schedule, since cardiac failure appeared imminent.
The patient was on a daily regimen of nicardipine at the time of surgery.
case author: Hugh S.
Mathewson, M.D., Professor Emeritus, School of Allied
Health, Department of Nurse Anesthesia, University of
Kansas Medical Center
case editor: Michael Gordon, Ph.D.
Associate Professor of Pharmacology and Surgery, School of
Medicine, Department of Pharmacology, University of Kansas
Medical Center
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Drug classification: nicardipine --
beta-blocker
alpha-adrenergic agonist
calcium channel blockers
beta-adrenergic agonist
prostaglandin analog
What is the most likely effect of cardiopulmonary bypass on myocardial perfusion in this patient?
significantly improved
somewhat improved
no change
somewhat diminished
significantly worsened
Pharmacological Management of Coronary Insufficiency
A 58 year-old man has been in progressive coronary insufficiency for at least five years, with angina of effort and recent early signs of left ventricular failure.