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Medical Video: All about angina
Prinzmetal angina, also called the angina variant, is a relatively rare cause of chest pain. Prinzmetal angina occurs when there is a spasm in one of the coronary arteries - arteries that provide blood to the heart. Even though it sounds scary, this condition can be cured. It is important to provide medical care carefully.
Prinzmetal angina is not a heart attack
Although it resembles a heart attack, prinzmetal angina is not the same. During a cardiac catheterization procedure, where the doctor can visualize the heart arteries, the arteries look normal. This shows that a heart attack is not the cause of the pain, but Prinzmetal is a possibility. This happens especially if the sick are women. In men, Prinzmetal angina occurs more frequently in coronary artery disease, so that cardiac catheterization in men may not show normal coronary arteries.
Who can be attacked? What caused it?
Anyone can experience it, but this condition is more common in women. Women who experience Prinzmetal angina are usually relatively young, and have several risk factors for heart disease, with the exception of cigarettes. (Smoking can make arterial spasms easier for some individuals.)
Prinzmetal angina can also be seen in users of cocaine or amphetamines, substances that produce arterial spasms. Users of illegal drugs with coronary artery spasms are more likely to experience permanent or fatal heart damage compared to non-users.
In certain cases, Prinzmetal angina is caused by endothelial dysfunction, in which the inner lining (endothelium) of the arteries does not work normally. Endothelial dysfunction is also associated with X syndrome, Raynaud’s phenomenon and migraine headaches. Women with Prinzmetal angina, in general, have a history of migraine headaches.
What are the symptoms of Prinzmetal angina?
In prinzmetal angina, chest pain is triggered by a small part of the main coronary artery that suddenly experiences seizures, stopping the flow of blood to the heart muscle provided by the artery for a while. At this stage, the electrocardiogram (ECG) shows a dramatic increase in ST segment, a change in ECG that is common in heart attacks. However, because the seizures disappear by themselves, there is a rare heart attack along with prinzmetal angina.
Although it can be triggered because of exercise, prinzmetal angina is more common when resting, usually in the morning, and occurs in succession.
How to diagnose Prinzmetal angina?
Prinzmetal angina is a concern if you feel serious chest pain accompanied by drastic ECG changes, but cardiac catheterization shows normal coronary arteries. The cardiologist will do a "provocative test" to see whether the coronary artery spasm can be induced or not. If so, prinzmetal angina can be diagnosed with certainty. Two types of provocation that are often used are hyperventilation and ergonovine. Hyperventilation tests are usually carried out in the morning (when seizures occur most often). This test requires the patient to breathe deeply and quickly for 6 minutes, using ECG monitoring and echocardiography to see the signs of a coronary artery spasm. This test is useful for patients who often experience serious prinzmetal angina. This test is not very effective in patients who rarely experience the prinzmetal angina stage.
The ergonovine test more often provides the right diagnosis than the hyperventilation test. In this test, ergonovine is given intravenously, usually during cardiac catheterization. Ergonovine increases "tone"Vascular and causes the arteries to constrict. In patients with prinzmetal angina, ergonovine often provokes the same local coronary artery spasm that causes chest pain. Local seizures can be visualized during the catheterization procedure. Fortunately, ergonovine-induced seizures can be returned with nitroglycerin drugs.
What are the consequences of Prinzmetal angina?
Although from outside the patient with prinzmetal angina looks fine, this condition can cause serious problems. Prinzmetal angina can trigger dangerous and potentially fatal cardiac arrhythmias, especially ventricular fibrillation. Although it is rare, a heart attack can occur and can cause permanent damage to the heart muscle. Proper treatment of prinzmetal angina can reduce the risk of these complications.
How do you handle Prinzmetal angina?
If you have prinzmetal angina, it is important that you maintain all your heart risk factors, and especially avoid products that contain tobacco.
Most likely you and your doctor can control the stages of angina with nitrates and / or calcium channel blockers. In addition, you can discuss the use of statins - a group of drugs that not only reduce cholesterol but also improve endothelial function - which according to the latest data can improve Prinzmetal angina.
Medications that can provoke a coronary artery spasm that you need to avoid include several beta blockers and migraine drugs, such as sumatriptan (Imitrex).
Hello Health Group does not provide medical advice, diagnosis or treatment.
