Which antianginal agent can be used for acute angina attacks?

Nitroglycerin is the primary choice for treating acute angina attacks due to its rapid onset of action. It is a nitrate that works by dilating blood vessels, which decreases the workload on the heart and improves blood flow to the myocardium (heart muscle). When administered sublingually, nitroglycerin can quickly relieve anginal pain within minutes, making it ideal for emergency situations.

In contrast, isosorbide dinitrate is a long-acting nitrate typically used for chronic management of angina rather than for immediate relief of acute attacks. Ranolazine is an antianginal medication that works by affecting myocardial metabolism and is often used for chronic angina as well. Amlodipine is a calcium channel blocker effective for hypertension and chronic angina management but does not act quickly enough to relieve acute angina attacks. Therefore, nitroglycerin stands out as the most suitable option for this scenario.