cardiovascular disorders
Variant Angina
Treatment of Variant Angina
Calcium channel blockers Sublingualnitroglycerin Average survival at 5 years is 89 to 97%, but mortality risk is greater for patients with both variant angina and atherosclerotic coronary artery obstruction. Risk increases with increasing obstruction. Usually, sublingualnitroglycerinpromptly relieves variant angina. Calcium channel blockers may effectively prevent symptoms. Theoretically, beta-blockers may exacerbate spasm by allowing unopposed alpha-adrenergic vasoconstriction, but this effect has not been proven clinically. Oral drugs most commonly used are calcium channel blockers: Sustained-releasediltiazem120 to 540 mg once a day Sustained-releaseverapamil120 to 480 mg once a day (dose must be reduced in patients with renal or hepatic dysfunction) Amlodipine5 to 10 mg once a day (dose must be reduced in older patients and in patients with hepatic dysfunction) Although all these drugs relieve symptoms, they do not appear to alter prognosis. 