Prinzmetal Angina: The Daily PANCE Blueprint
Which of the following medications should be avoided in those with Prinzmetal angina?
A. Diltiazem
B. Amlodipine
C. Nitrates
D. Clonidine
E. Metoprolol
Answer and topic summary
The answer is E. Metoprolol
Prinzmetal angina (aka vasospastic angina) is defined by spasms of the coronary arteries that lead to chest pain at rest (with concurrent EKG changes in the ST segment). Etiologies include exposure to cold weather, exercise, and substances (cocaine, pseudoephedrine, etc). A typical clinical presentation is chronic patterns of chest pain at rest that last 5-15 minutes in the early morning. Work-up many include 12-lead EKG, troponin levels, stress test, and coronary arteriography with provocative testing. Treatment includes avoiding triggers, sublingual nitroglycerin as needed, and taking calcium channel antagonists (e.g., diltiazem, amlodipine,). Beta-blockers should be avoided as they can aggravate symptoms.
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Cardiology ⇒ ⇒
Also covered as part of the HEREEOR, HEREEOR, and topic lists
