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