Prinzmetal Angina

Overview
  • Prinzmetal Angina, also known as Variant Angina, is a syndrome of episodic chest pain caused by sudden, inappropriate vasospasm of coronary arateries.
Etiology and Pathogenesis
  • The etiology of this condition is not well-understood; however, inappropriate vasospasm occurs in segments of apparently health coronary artery. Thus, historically this condition was thought to be unrelated to Atherosclerotic Plaques. However, affected arteries may in fact possess early stages of atherosclerosis that possibly induce vasospasm in inappropriately sensitive arteries. Whatever the case, brief episodes of inappropriate vasoconstriction of coronary artery segments reduces cardiac blood flow to the point that it cannot meet cardiac oxygen demand, resulting in transient myocardial ischemia. Because these episodes are brief and reversible, coronary artery vasospasm does not lead to more serious myocardial infarction.
Clinical Consequences
  • Prinzmetal Angina is characterized by severe episodes of transient anginal chest pain that can occur at rest and can wake a patient from their sleep. Curiously, attacks are associated with temporary ST Segment elevation.
Epidemiology
  • Prinzmetal Angina tends to occur in younger patients with fewer cardiovascular risk factors. Interestingly, this condition is sometimes co-morbid with other vascular disorders such as Raynaud Phenomenon and many patients suffer from frequent migraines.