Cardiology: Prinzmetal angina: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Cardiology: Prinzmetal angina

Sample item

A 40-year-old smoker has rest chest pain at night with transient ST elevation that resolves with nitroglycerin. Angiography shows normal coronaries. Which drug is first-line?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Calcium channel blocker

Prinzmetal variant angina is due to coronary vasospasm. Calcium channel blockers and nitrates are the mainstay. Nonselective beta blockers can leave alpha vasoconstriction unopposed and worsen spasm.

Option by option

  • A. Calcium channel blocker (correct)

    Correct. CCBs and nitrates relieve vasospasm.

  • B. Ranolazine

    Ranolazine has little role in vasospastic angina.

  • C. Aspirin alone

    Aspirin does not treat vasospasm, and high doses may worsen it.

  • D. Propranolol

    Propranolol may aggravate spasm by unopposed alpha activity.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Calcium channel blocker. Prinzmetal variant angina is due to coronary vasospasm.

Why is "Ranolazine" not the answer?

Ranolazine has little role in vasospastic angina.

Why is "Aspirin alone" not the answer?

Aspirin does not treat vasospasm, and high doses may worsen it.

Why is "Propranolol" not the answer?

Propranolol may aggravate spasm by unopposed alpha activity.

What concept does this question test?

It tests Cardiology: Prinzmetal angina in General Medicine. Calcium channel blockers and nitrates are the mainstay. Nonselective beta blockers can leave alpha vasoconstriction unopposed and worsen spasm.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiology: Prinzmetal angina?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.