Which is one of the four types of angina?

• A. Hypertensive angina
• B. Prinzmetal or Variant Angina
• C. Stable angina
• D. Infectious angina

Answer: (B)

Angina types reflect different mechanisms of myocardial ischemia. There are four classic categories: stable angina from fixed epicardial narrowing, unstable angina representing a change in the pattern or severity, variant (Prinzmetal) angina caused by transient coronary vasospasm, and microvascular angina due to dysfunction of small vessels.

Prinzmetal or Variant Angina is the vasospastic type. It presents with chest pain that often occurs at rest (sometimes at night) and can be associated with transient ST-segment elevations on ECG during the episode, signaling transmural ischemia. The key feature is that the ischemia is not driven by exertion or fixed plaque alone but by reversible spasm of the coronary arteries. Episodes tend to respond to vasodilators such as nitrates and calcium channel blockers, and avoiding triggers like smoking can help reduce episodes. This distinct mechanism—spasm-induced ischemia with possible ST elevations—makes it one of the four recognized angina types, separate from stable angina, which is exertion-related and due to fixed atherosclerotic narrowing.

Infectious angina is not a recognized category, and hypertensive angina isn’t a standard clinical type, while stable angina is indeed a type, but the statement here highlights Prinzmetal angina as the classic vasospastic form among the four.