Abstract
Myocardial ischemia occurs when there is a supply and demand imbalance between the delivery of oxygenated blood to the myocardium and the needs of the myocardium to maintain normal cardiac function at any level of activity. The commonest cause of the imbalance is obstructive coronary artery disease. A pharmacologic hemodynamic approach to therapy principally focuses on reducing demand (slowing heart rate, lowering blood pressure, reducing contractility and increasing peripheral venous and arterial vasodilatation), with a variable effect on supply (coronary vasodilatation).
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