A 52-year-old male smoker experiences chest pain at rest with transient ST elevation that resolves spontaneously. Coronary angiography reveals no significant stenosis. Which medication is contraindicated in this condition?
- A Propranolol ✓
- B Nitroglycerin
- C Nifedipine
- D Amlodipine
Correct answer: A. Propranolol
Explanation
Variant angina is caused by coronary artery spasm. Calcium channel blockers and nitrates relieve spasm. Beta-blockers are contraindicated because blocking beta-2 mediated vasodilation leaves unopposed alpha-1 mediated coronary vasoconstriction, worsening the spasm. Nifedipine and amlodipine are calcium channel blockers that treat this condition.
Reference: Katzung Basic and Clinical Pharmacology, 15th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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