Can sildenifil be used as an alternative for nitrates in Angina management? In short - no! The coronary spasm that is at the heart of Angina (see what I did there?) is caused by excess vasoconstrictor activity (e.g., endothelin, sympathetic drive, smooth muscle hyper- reactivity). So- given that Phosphodiesterase isn’t implicated in triggering angina, blocking it achieves nothing . | ECT4Health- Nurse/Paramedic Education
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