Understanding Prinzmetal Angina

Prinzmetal's angina, named by the researcher who first discovered it in 1959, is one of the several forms of angina.
What is prinzmetal angina? What cause it? What is coronary artery spasm? What are symptoms? Diagnosis? Treatment? Prognosis? 
Answers on all those questions we will provide on this pages.

Understanding what Angina is!

Angina is pain in chest which in most cases occur during physical activity or because of emotional stress. This pain is a short term and usually disappear in a several minutes of rest or by taking medicine. What's behind the pain: narrowed arteries (caused by coronary heart disease), that reduce oxygen and blood supply to the heart.

Forms of angina are many, but in general there are three types of angina:
  • Stable angina
  • Unstable angina
  • Microvascular angina

What is Prinzmetal Angina?

Prinzmetal angina, also known as prinzmetal’s variant angina, is a form of unstable angina. Pain in chest usually happen without a predictable pattern, while resting, early in the morning, but also can be caused because of emotional stress.

Behind this pain is tightening of the arteries that supply heart with blood, known as coronary artery spasm. This spasm is reducing the oxygen and nutrients flow to the heart in one or more of coronary arteries and sometimes even can completely block coronary artery.

Artery spasms may vary from trivial to very serious. What's the most dangerous is, if the spasm last for even more than 10-15 minutes, there is a high risk for heart to survives permanent damage. This kind of attacks can even lead to heart attacks or sudden death. If heart stay to long without its needs for blood and oxygen it suddenly cause abnormal rhythm (arrhythmia) which can lead to heart failure and death.

What are the Causes of Coronary Artery Spasm?

Coronary arteries are in charge to carry oxygen-rich blood to the heart. When fatty material known as plaque accumulates on the inner walls of the coronary arteries it makes them become narrowed and cause coronary artery spasm, these condition known as atherosclerosis.

High blood pressure and high cholesterol are in most cases the reasons for developing of coronary artery spasm. People who smoke are in general more likely to have it than nonsmokers. Sometimes it happens without any reason but in most cases it is  induced by: emotional tension, medications that narrows blood vessels, or exposure to cold. Bad life habits such are usage of drugs and alcohol can also be triggers.

What are the Symptoms of Prinzmetal Angina?

The main symptom of Prinzmetal Angina is severe chest pain, but these pain can include the other areas of body such are:
  • Arms and/or shoulders
  • Jaw and/or neck
  • Chest and/or back
If you experience a pressure-like discomfort in or around those areas, you should ask your doctor for prinzmetal angina.

How is Prinzmetal angina diagnosed?

Before any testing your health provider will ask several questions about symptoms and if conclusions leads to Prinzmetal's angina, doctor will proceed to tests. If a patient has severe chest pain, ECG or EKG (electrocardiogram) is next step to check the condition of heart. ECG shows the heart's electrical activity on the graph and if there are dramatic changes doctor will proceed to the next step, so called "provocative testing".

There are two types of those tests:
  • Hyperventilation - for patients who are more affected by severe chest pain, in most cases performed early in the morning, time when coronary artery spasm is most likely to happen. While patient inhale and exhale fast and deeply, doctor is monitoring on the ECG graph for signals of spasm. This test diagnoses are very accurate.
  • Ergonovine - test is performed by intravenously given drug named ergonovine; medicine will cause arteries to shrink, patients with prinzmetal angina are vulnerable to have the same chest pain provoked by coronary artery spasm induced by medicine and quickly stopped by usage of nitroglycerin. This test is giving more accurate diagnose then hyperventilation.

How Is Prinzmetal Angina Treated?

The chest pain caused by spasms are very unpleasant (especially in cases of severe), that's why each sufferer should access very seriously to  treating it. The treatment of Prinzmetal's Angina is based on usage of medications which influence on the coronary artery spasms by reducing them.
  • Nitroglycerin
  • Calcium Channel Blockers
  • Beta Blockers
  • Aspirin Therapy
  • Smoking Cessation

Prinzmetal Angina is rare illness, however a small percent of people who suffer from the chest pain, would like if they could change their habits on time. 

Remember that prevention is the best "cure" for every disease, always give your best to change your habits before it's to late.