PRINZMETAL’S VARIANT ANGINA

This is a syndrome of ischemic pain at rest and with ECG showing transient ST elevation.

• This sydrome is caused by spasm of coronary artery leading to severe ischemia. It may occur in patients who may not have any coronary artery stenosis.
• It is a kind of vasospastic disease like Raynaud’s phe­60menon. It may occur in young persons and smokers. Cardiac examination may be normal.
• Coronary angiography may show transient coronary spasm close to area of coronary stenosis.

PRINZMETAL’S OR variant angina:

• Chest pain that results from the spasm of coronary arteries, rather than from exertion or other increased demands on the heart.
• On the electrocardiogram, the diagnostic hallmark is elevation of the ST segments during episodes of resting pain.
• ECG shows ST segment elevation which reverts to normal.
• Serum markers may be elevated or normal.
• The pain typically occurs at rest. During coronary catheterization, the spasm is usually found near an atherosclerotic plaque, often in the right coronary artery.
• Infusions of ergonovine may provoke it.

PRINZMETAL’S OR variant angina Treatment:

• Nitrates,
• calcium channel blockers,
• sub­lingual or IV Nitrates and Prazosin.
• Aspirin may in­crease the severity of attack.