Registered Cardiovascular Invasive Specialist (RCIS) Practice Test

Which drug is the first line treatment for coronary spasm?

1. Aspirin

2. NTG

3. Lidocaine

4. Dopamine

The correct answer is: NTG

Nitroglycerin (NTG) is the first-line treatment for coronary spasm, also known as Prinzmetal's angina. This condition occurs when the coronary arteries temporarily constrict, leading to a decrease in blood flow and oxygen to the heart muscle. NTG works as a potent vasodilator, which means it relaxes the smooth muscles within the blood vessel walls. By dilating the coronary arteries, NTG helps to increase blood flow to the heart, alleviating the chest pain associated with coronary spasm. The rapid onset of NTG makes it particularly effective in acute situations where relief from ischemic chest pain is needed. The drug can be administered sublingually for quick absorption or through other routes, depending on the clinical scenario. In contrast, other options serve different primary purposes or are not indicated for treating coronary spasms. Aspirin is mainly used as an antiplatelet agent to prevent blood clots. Lidocaine is primarily an antiarrhythmic medication used in the treatment of ventricular arrhythmias. Dopamine, while used in certain cardiogenic shock scenarios to support heart function, does not address the vasospasm itself. Therefore, NTG is the most appropriate choice for managing coronary spasms specifically.