What is Prinzmetal's Angina?

Prinzmetal's angina is a heart condition where the coronary arteries spasm while someone is at rest, causing chest pain and potentially leading to the development of arrhythmias. This condition is highly treatable with medications and surgery in extreme cases, although it can be difficult to accurately diagnose. Patients who experience chest pain are usually advised to seek treatment with a cardiologist and may need to undergo testing in a cardiology laboratory, where people specialize in diagnosing and treating heart conditions.

Also known as atypical or variant angina, Prinzmetal's angina occurs at random, rather than in response to specific triggers. The patient may be asleep or in a resting state, and the pain can start in the chest and radiate outward. The pain may be experienced as tightness or intense pressure in the chest, and once it passes, the chest will feel normal again and the heart should beat regularly. In very rare cases, patients may experience a myocardial infarction as a result of restricted bloodflow to the heart during an angina attack.

Coronary artery disease, high levels of stress, and smoking are all associated with Prinzmetal's angina. The condition can occur in people of all ages, including younger adults, illustrating the importance of seeking treatment for chest pain even if a person thinks that heart conditions are unlikely due to age and general levels of fitness. A cardiologist can interview a patient and recommend testing to find out more about what is happening.

Diagnosis of Prinzmetal's angina requires getting a reading on electrical activity in the heart while an attack is occurring. This can be challenging, as the angina attacks don't occur in response to replicable conditions like exercise. Some labs may use challenges in an attempt to induce an angina attack to collect diagnostic information. The testing can vary in length, depending on how many tests are ordered, and patients may need to secure a ride home afterward if medications were used during the testing.

Nitrates and calcium blockers can be used in the management of Prinzmetal's angina. These treatments are usually sufficient on their own to treat the patient's heart condition. If the patient continues to experience angina attacks or does not improve, angioplasty may be recommended to address the spasming arteries and prevent future attacks of chest pain. Angioplasty procedures are only advised when they are the last available treatment option, as they can be invasive and, as with any surgical procedure, can carry risks.