Prinzmetal's Angina

Prinzmetal's angina

• Also known as vasospastic or variant angina
• Angina results from coronary spasm producing transient ST elevation
• Patients are younger and often do not have the classic risk factors for CAD (with the exception of cigarette smoking)
• May be associated with migraine or Raynauld's phenomena
• Cocaine an important risk factor
• Exercise and hyperventilation can rarely precipitate attacks. Usually occurs at rest
• Increased prevalence of attacks during the night
• Often have obstructive coronary lesions as well
• May be precipitated with ergonovine or hyperventilation during cardiac cath
• Treatment involves use of calcium channel blockers and nitrates. Beta blockers and aspirin should not be used. Estrogen may help some postmenopausal women