Acute anginal attack can be terminated by: September 2007
**Core Concept**
Acute anginal attacks are caused by a transient imbalance between myocardial oxygen supply and demand, often due to coronary artery spasm or thrombosis. **Myocardial ischemia** occurs when the heart muscle does not receive enough oxygen-rich blood. **Nitric oxide** and **vasodilators** play a crucial role in managing angina by improving blood flow.
**Why the Correct Answer is Right**
The correct answer is related to the use of **nitroglycerin**, a vasodilator that reduces myocardial oxygen demand by decreasing preload and afterload, thereby improving blood flow to the ischemic area. **Nitric oxide** release from nitroglycerin leads to relaxation of vascular smooth muscle, causing vasodilation.
**Why Each Wrong Option is Incorrect**
**Option A:** Incorrect because it is not specified, but typically, options like morphine or beta-blockers might be considered, which, although useful in managing angina, are not the most direct way to terminate an acute attack.
**Option B:** Incorrect for similar reasons as Option A, lacking specificity but potentially referring to a less direct method of relieving angina.
**Option C:** Incorrect as it is not the most appropriate choice for immediate relief of an acute anginal attack.
**Option D:** Incorrect because, while important in management, it's not the immediate choice for terminating an acute attack.
**Clinical Pearl / High-Yield Fact**
Remember, **nitroglycerin** is the first-line treatment for acute anginal attacks due to its rapid onset of action and effectiveness in relieving ischemic chest pain.
**Correct Answer:** D. Nitroglycerin.