Which class of pharmacological agents would most likely be used to treat an acute angina attack?

Nitrates are the pharmacological agents most commonly used to treat an acute angina attack due to their rapid action in dilating blood vessels. During an angina episode, the heart muscle experiences ischemia, which is often linked to limited blood flow caused by coronary artery disease. Nitrates work by relaxing the smooth muscles in blood vessel walls, leading to the dilation of coronary arteries as well as other veins and arteries. This increased blood flow helps to relieve the chest pain associated with angina by enhancing oxygen delivery to the myocardium and reducing myocardial oxygen demand.

In addition, nitrates can be administered sublingually or via spray for quick onset of action, making them particularly effective in the acute scenarios presented by angina attacks. While the other classes of medications, such as calcium channel blockers, diuretics, and beta blockers, can be used for overall management of heart conditions including prevention of angina, they do not have the same immediate effectiveness in relieving acute angina symptoms as nitrates do.