Aggravation of symptoms of angina in a patient when given nitrates is seen in :
Aortic regurgitation
Mitral regurgitation
Single left coronary artery stenosis
Idiopathic hypertrophic subaortic stenosis
Ans. is 'd' i.e Idiopathic Hypertrophic Sub Aortic Stenosis As already explained in Nov. 2000, idiopathic hypertrophic subaortic stenosis (or HOCM) is a dynamic outflow obstruction which is increased by any mechanism decreasing the preload (Nitrates decrease the preload significantly)Nitrates decrease the obstruction in AR & MRIn single left coronary artery stenosis, nitrates are helpful. By decreasing the preload decrease the cardiac work done (and hence decreased 02 requirement). A decrease in preload also improves the subendocardial perfusion (because of decrease in end-diastolic pressure, the sub-endocardial crunch is abolished).
M.I. & Angina