What Is the Treatment of Variant Angina?
Variant angina (ICD-11 BA85 / ICD-10 I20.1) requires a structured pharmacological approach. The protocol defines a systematic escalation strategy for patients whose spasm control is inadequate on initial doses.
Therapeutic Approach
Management centres on progressive dose escalation of calcium channel blockers, with combination nitrate therapy as a further adjunct — the full titration sequence, specific agents, and escalation criteria are outlined in the complete protocol.
References
DOI: 10.15420/ecr.2022.47
- In a subset of these patients, adequate control of CAS is obtained with the use of increasing doses of CCBs, titrated up to the maximum tolerated dose (e.g. up to 960 mg/day diltiazem or verapamil) and possibly combined with nifedipine (up to 100 mg) or amlodipine (up to 20 mg).
- Similarly, high doses of nitrates can be added (e.g. 80 mg ISDN or isosorbide-5-mononitrate) or maximum tolerated doses of continuous intravenously administered nitrates (nitroglycerin, ISDN).
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