How is vasospastic angina typically treated?

Vasospastic angina, also known as variant angina or Prinzmetal angina, is characterized by episodes of chest pain due to transient coronary artery spasm, often occurring at rest and commonly during the night or early morning. The primary goal of treatment is to alleviate the spasms and prevent future episodes.

The most effective treatment for vasospastic angina includes nitrates and calcium channel blockers. Nitrates work by dilating blood vessels, which helps to relieve the spasm and improve blood flow to the heart. Calcium channel blockers are particularly useful as they directly inhibit the contraction of smooth muscle in the coronary arteries, thus helping to prevent spasms.

In contrast, other medications listed, such as beta blockers and ranolazine, while helpful in managing chronic stable angina, are not typically the first line for vasospastic angina due to their mechanisms, which do not directly target the causes of coronary artery spasm. Additionally, medications like statins and diuretics or ACE inhibitors and aspirin do not specifically address coronary vasospasm, focusing instead on other aspects of cardiovascular health.

Therefore, the selection of nitrates and calcium channel blockers provides targeted therapeutic effects necessary for managing vasospastic angina effectively.