Calcium Channel Blocker, probably a stupid question?

Editorial Team / Admin · Oct 23, 2005

I recently had a Hearview scan. I haven't received the results yet. I know the results include whether or not calcium is seen and there can be a calcium level. I have been on Calan SR 240 for at least 15 years. Does this block calcium from accumlating in the heart? I know it works for my SVT and PVC's but other than that I'm not sure how it works. Thanks.

Hello, dutchgirlRN,:balloons:

That is NOT a stupid question at all. (And, haven't you been told......there are NO stupid questions?).

First, clogged coronary arteries are caused by plaque buildup. Plaque is made up of cholesterol, fat, and, yes, you guessed it.....calcium. As you know this (plaque) clogs and narrows arteries.

Now, blood vessels have calcium channels just like the myocardium. But, calcium in the vessels can cause the vessel to tighten, and decrease the width of the vessel. Calcium channel blockers , block the flow of calcium through the calcium channels of the vessels.

So, I suppose to make a long story short, yes, the calan has blocked calcium and therefore the result should be lesser buildup, if at all.....of calcium.:)

DutchgirlRN, ASN, RN · Oct 23, 2005

Hello, dutchgirlRN,:balloons:
That is NOT a stupid question at all. (And, haven't you been told......there are NO stupid questions?).
First, clogged coronary arteries are caused by plaque buildup. Plaque is made up of cholesterol, fat, and, yes, you guessed it.....calcium. As you know this (plaque) clogs and narrows arteries.
Now, blood vessels have calcium channels just like the myocardium. But, calcium in the vessels can cause the vessel to tighten, and decrease the width of the vessel. Calcium channel blockers , block the flow of calcium through the calcium channels of the vessels.
So, I suppose to make a long story short, yes, the calan has blocked calcium and therefore the result should be lesser buildup, if at all.....of calcium.:)

Wow Siri Thanks! I really appreciate the answer and especially the explanation. Also thanks for reminding me that there are no stupid questions except the ones not asked. :thankya:

Editorial Team / Admin · Oct 23, 2005

The heart scan only shows calcium buildup in/around arteries. We've had pts referred for a heart cath who had a strongly positive CTA (CT Angiogram = heart scan), whose arteries were VERY open (i.e., NO STENOSES, NO BLOCKAGES). I think either 1) perhaps our scanner isn't equipped with the newest and greatest software for reconstructing the images, 2) enough studies haven't been done correlating the two (CTA and Cardiac Catheterization), to determine if the calcium showing in the heart scan is a problem (flow-limiting).

Any others? I'm sure it's a good screening tool, but I wouldn't stake everything on its results ONLY. Ppl present so differently, need to look at the total picture: EKG, stress test, good clinical history, co-morbidities, presence of chest discomfort (or its equivalent = arm pressure, jaw discomfort, etc), nuclear study . . . and remember that most studies can give false positives and false negatives . ... .

:)

Editorial Team / Admin · Oct 23, 2005

Wow Siri Thanks! I really appreciate the answer and especially the explanation. Also thanks for reminding me that there are no stupid questions except the ones not asked. :thankya:

You are welcome. :)

Editorial Team / Admin · Oct 23, 2005

The heart scan only shows calcium buildup in/around arteries. We've had pts referred for a heart cath who had a strongly positive CTA (CT Angiogram = heart scan), whose arteries were VERY open (i.e., NO STENOSES, NO BLOCKAGES). I think either 1) perhaps our scanner isn't equipped with the newest and greatest software for reconstructing the images, 2) enough studies haven't been done correlating the two (CTA and Cardiac Catheterization), to determine if the calcium showing in the heart scan is a problem (flow-limiting).
Any others? I'm sure it's a good screening tool, but I wouldn't stake everything on its results ONLY. Ppl present so differently, need to look at the total picture: EKG, stress test, good clinical history, co-morbidities, presence of chest discomfort (or its equivalent = arm pressure, jaw discomfort, etc), nuclear study . . . and remember that most studies can give false positives and false negatives . ... .
:)

Excellent observation, dianah. :balloons: You are correct. I know "they" say this will take the place of card cath in asymptomatic patients, but, I am not sold on this as yet.

I need much proof.

DutchgirlRN, ASN, RN · Oct 23, 2005

:redbeathe The Heartview scan is advertised as the newest most advanced CTA in the country and we are the only hospital in the southeast to have it. (so the administration has told us) The hospital has been generous enough to offer the test to every employee and one family member for $25. Several employees have left the scan to have a CABG before even having any S/S. One particular employee was in his 40's and had no S/S, was a non-smoker, very athletic and no family hx of heart disease. I have no risk factors for heart disease nor do I have any S/S but hey for $25 I'd be a fool not to take advange of having it done. The tech said to me my scan looked great but I'm looking forward to hearing it from the cardiologist reading my scan. I agree it shouldn't replace a heart cath but do believe it is a very worthwhile diagnostic tool.

P.S. The day I had mine done was the same day Oprah featured it on her show and she had one done. It was very interesting.

papawjohn · Oct 23, 2005

Hey DutchgirlRN

My .02 worth. You said your Calan works on your SVT and PVCs but that you didn't understand just how. (It also decreases BloodPressure.)

You'll remember that the cardiac muscle has this cool capacity called 'automaticity'--that it stimulates itself to contract "automatically". How does it do that? (I've wished my brain had some similar capacity and my mouth had less!!!)

The cardiac cell has several 'gates' or 'channels' that depend on a build-up of a particular electrolytes to work. Obviously, one of these is the Ca++ ion. There is a 'fast' channel and a 'slow' channel--but that's WAAAY back in the dark recesses of my memory.

Here's how I explain to newbies how the CaChannelBlocker works: Imagine that there is a medieval tower with a big bell on top. There is a bell-ringer who lives on the bottom level of this tower. Very regularly he has to rush up the stairs and ring the bell. OK? A silly picture--but helpful if you imagine that this tower is a cardiac cell in the sinus node. And the bell being rung is the start of a cardiac cycle. Can you imagine this?

Our bell ringer goes rushing up the stairs from his apartment to the Bell and along the way there is this sequence of shuttered windows. As he charges upward, he has to pause and open each of these shutters. (In my mind, I see him looking out the windows to check the time on the clocks of his town, so that he doesn't ring the bell early or late.)

What if we partially blocked one of those shutters? The bellringer would have to stand on the stairs and wrestle with it until he got the window open, right? And so he wouldn't be able to get up the stairs early to ring the bell.

The shuttered window is the CaChannel. Calan makes the shutter harder to swing open and slows down the bellringing--heart rate. And that is my childish picture of how "blocking" a particular "channel" controls your heart rate.

I had no idea that Calan had any effect on plaque. Thanx for that part SIRI.

Papaw John

DutchgirlRN, ASN, RN · Oct 23, 2005

Hey DutchgirlRN Imagine that there is a medieval tower with a big bell on top. There is a bell-ringer who lives on the bottom level of this tower. Very regularly he has to rush up the stairs and ring the bell. OK? A silly picture--but helpful if you imagine that this tower is a cardiac cell in the sinus node. And the bell being rung is the start of a cardiac cycle. Can you imagine this? Our bell ringer goes rushing up the stairs from his apartment to the Bell and along the way there is this sequence of shuttered windows. As he charges upward, he has to pause and open each of these shutters. (In my mind, I see him looking out the windows to check the time on the clocks of his town, so that he doesn't ring the bell early or late.) What if we partially blocked one of those shutters? The bellringer would have to stand on the stairs and wrestle with it until he got the window open, right? And so he wouldn't be able to get up the stairs early to ring the bell. The shuttered window is the CaChannel. Calan makes the shutter harder to swing open and slows down the bellringing--heart rate. And that is my childish picture of how "blocking" a particular "channel" controls your heart rate. Papaw John

Huh? Actually that just confused me. Sorry, maybe it's just me I'm tired. I know Calan is an antihypertensive. I just wasn't sure how it kept my SVT and PVC's in check. I understand the cardiac cycle I just got lost when the bell ringer encountered the shutter that would not open. Sorry, like I said I'm very tired. Over 4 hours on allnurses, it's time to go to bed. :sleep:

I'll read your post again in the morning. Perhaps it will make more sense to me then. Thanks.

Editorial Team / Admin · Oct 23, 2005

If I had the chance to have a heart scan for $25, I'd certainly get one!! :) :) When my facility got a new bone density scanner, all the Radiology employees were asked if they would have one, gratis, so the tech could get some hands-on experience. Yes, being over 40, I jumped at the chance (and copied the results and forwarded them to my PCP)!

My only point was, heart scan is not yet 100% reliable predictor of CAD. That's all. :) :)

papawjohn · Oct 23, 2005

Hey DutchgirlRN

I can't stand thinking I've made someone more confused. I apologize. I re-read my post and see why it doesn't seem clear. (It works so much better when I can draw a picture of a bell-tower in the atrium of a heart....)

There is lots of information on the ca++ channels on line. It's almost all very dense and complex and not so helpful to Nurses that 'only' need to work with these kinda things or pts who 'only' have to take them. Here's a link:

http://www.anaesthetist.com/icu/organs/heart/ion.html

The simple way of saying it begins with 'automaticity'. The heart needs a method of causing it's own beats--but not too fast, not too slow. It does this by having little windows which must be open in a certain series. (They're actually called 'gates' or 'channels'.) There are lots of these!!! There are apparently 6 different calcium channels!! There are potassium channels and sodium channels. All kinds of 'channels'.

Here's the point of my silly bell-ringer: All of these have to open in sequence. OK? See how the heart regulates its 'timer' by having all these 'shutters' open in sequence? (That was the point of the bell-ringer running up the stairs opening shutters as he goes--that it is in sequence and takes a certain amount of time--so it makes a 'schedule' for each heartbeat.

Slowing down one channel with CALAN slows the entire series and so slows the heartbeat. Perhaps you remember phrases like "action potential" and "refractory period"--well, it's stuff like that which are controlled by 'blocking' that calcium channel.

The vascular cells (not cardiac cells) have similar channels. Since they don't "beat"--the calcium blockade causes them to have less tension, less 'squeeze' on the blood. So CALAN also lowers the BP.

Hope that's clearer.

Papaw John

JentheRN05, RN · Oct 23, 2005

Hey DutchgirlRN
My .02 worth. You said your Calan works on your SVT and PVCs but that you didn't understand just how. (It also decreases BloodPressure.)
You'll remember that the cardiac muscle has this cool capacity called 'automaticity'--that it stimulates itself to contract "automatically". How does it do that? (I've wished my brain had some similar capacity and my mouth had less!!!)
The cardiac cell has several 'gates' or 'channels' that depend on a build-up of a particular electrolytes to work. Obviously, one of these is the Ca++ ion. There is a 'fast' channel and a 'slow' channel--but that's WAAAY back in the dark recesses of my memory.
Here's how I explain to newbies how the CaChannelBlocker works: Imagine that there is a medieval tower with a big bell on top. There is a bell-ringer who lives on the bottom level of this tower. Very regularly he has to rush up the stairs and ring the bell. OK? A silly picture--but helpful if you imagine that this tower is a cardiac cell in the sinus node. And the bell being rung is the start of a cardiac cycle. Can you imagine this?
Our bell ringer goes rushing up the stairs from his apartment to the Bell and along the way there is this sequence of shuttered windows. As he charges upward, he has to pause and open each of these shutters. (In my mind, I see him looking out the windows to check the time on the clocks of his town, so that he doesn't ring the bell early or late.)
What if we partially blocked one of those shutters? The bellringer would have to stand on the stairs and wrestle with it until he got the window open, right? And so he wouldn't be able to get up the stairs early to ring the bell.
The shuttered window is the CaChannel. Calan makes the shutter harder to swing open and slows down the bellringing--heart rate. And that is my childish picture of how "blocking" a particular "channel" controls your heart rate.
I had no idea that Calan had any effect on plaque. Thanx for that part SIRI.
Papaw John

Papaw! That was an incredible description. I like that kind, having a little twist, I will remember that next time I have to educate a patient on Calan (which won't be any time soon, I work on an ortho/neuro floor), BUT it happens obviously from time to time!