Download Chapter 6 CARDIOVASCULAR ARRHYTHMIAS AND

Chapter 6
Drugs for
Cardiovascular
Arrhythmias and
Hypertension
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 Hank Gathers
 hypertrophic cardiomyopathy
 Flo Hyman
 Marfan’s syndrome
 Jim Fixx
 atherosclerotic coronary artery disease
 Darryl Kile
 atherosclerotic coronary artery disease
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 “Pistol” Pete Maravich
 abnormal coronary arteries
 Len Bias
 illegal drugs
 High School versus College Athlete
 Changing cardiovascular development
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Arrhythmias
 “Irregular heart action caused by
physiological or pathological
disturbances in the discharge of cardiac
impulses from the sinoatrial node or their
transmission through conductive tissue of
the heart.”
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Arrhythmias
 Medications control arrhythmias and
assist the heart in maintaining a normal
rhythm
 Device-based techniques
 Implantable pacemakers or defibrillators
 Can result in syncope, fatal in certain
sports
 Table 6-1, pg 82
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Arrhythmias
 Common Forms of Arrhythmias
 Table 6-2,pg 83
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Arrhythmia Medications
 Four subclassifications
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Class I
Class II
Class III
Class IV
Sodium channel blockers
β-adrenergic blockers
Potassium channel blockers
Calcium channel blockers
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Adverse Effects

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Lethargy
Fatigue
Bradycardia
Orthostatic hypotension
Cold extremities
Rashes, pruritus, headache, nausea,
diarrhea, swelling, behavioral
disturbances, disorientation
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Adverse Effects (cont.)
 Despite the purpose of reducing
arrhythmias one of the most common
side effects of the anti arrhythmic drugs is
the increase in rhythm disturbances.
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Antiarrhythmic Drug
Interactions
 Table 6-3, pg 85
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Device Therapy
 Pacemakers – first implanted (1958)
 Implantable cardioverter defibrillators
(ICD) – (1980)
 Not common in athletes
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Hypertension
 Hypertension is the “pressure in the
pipes”
 Diet, stress, genetics, etc.
 Approximately 24% of population
 Females have higher rates
 BP > 140 mm Hg
 on three separate occasions
 Essential hypertension
 No known cause
 Secondary hypertension
 Diagnosable cause
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BP Classifications
 Normal
<120/<80
 Prehypertension 120 –139/80–89
 Hypertension
 Stage 1
 Stage 2
 Stage 3
140 – 159/90 – 99
>160/>100
Physician’s care
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Monitor variables that can
affect BP
 Salt and intake of high-sodium and highfat foods (PJ)
 Alcohol
 Over-the-counter stimulants caffeine/cold medication
 Diet pills
 Smoking or chewing tobacco
 Cocaine or anabolic steroids
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Medications for
Hypertension
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

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
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Diuretics
Calcium channel blockers
ACE Inhibitors
Angiotensin II blockers
Beta blockers
Alpha-blockers
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Adverse Effects
 Diuretics
 Orthostatic hypotension
 Dehydration – electrolyte imbalance
 ACE inhibitors
 Cough
 Beta blockers
 Bradycardia, fatigue, dizziness
 Alpha-blockers
 Tachycardia/orthostatic hypotension
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Hypertension in the
Athlete/Active Population
 Table 6-6, pg 88
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What to Tell the Athlete
 Page 88
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