Treatment of prinzmetal’s angina
Vasospastic angina is a cardiac condition, and treatment shouldn’t only focus on the spasm but also on overall cardiac health. In many patients with Prinzmetal’s angina, atherosclerosis is coexistent and should be managed as well through lifestyle measures as physical exercise and diet in addition to the pharmacologic treatment through antiplatelets, statins, and anticoagulants. If atherosclerosis is absent, however, such pharmacologic therapy is unnecessary.
Targeted therapy towards vasospasm includes:
1) Pharmacologic therapy
Pharmacologic therapy aims to relax the vessel wall’s smooth muscles in the short term and prevent the recurrence of their spasm. For short term relief, nitrates are the drugs of choice. Sublingual or intravenous nitrates act within a few minutes, and their effect is outstanding. For long term prevention or “prophylaxis” against attacks, drugs include either long-acting nitrates or calcium channel blockers.
Calcium channel blockers as amlodipine are commonly used as they have a long duration of action. They act by blocking calcium channel, preventing its influx into the muscle fibers, and since calcium is essential for the contraction of muscles, this causes relaxation of the vessel walls.
