Pain, when present, seemed just a concomitant symptom not significantly interfering with the circulatory changes associated with the episodes of this form of angina pectoris. [heart.bmj.com]

Conclusion: A thorough case history is of vital importance in a patient presenting with a history suggestive of variant angina. [pubmed.ncbi.nlm.nih.gov]

Sign in CorrespondenceFree PreviewArchive Variant Angina Pectoris Related Articles To the Editor: Whiting and his co-workers presented a fine clinical description of a patient with a, variant form of angina pectoris (N.E.J.M. 282:709–712, 1970). [nejm.org]

The patient re-presented with another myocardial infarction, requiring up-titration of medical therapy. [smj.org.sg]

In this issue of The Journal, p. 1794, clinical and experimental evidence is presented which furthers our understanding of coronary artery disease. [jamanetwork.com]

• Coronary Atherosclerosis

  Such response could not be predicted by demographic factors, ECG changes, or degree of coronary atherosclerosis. [ncbi.nlm.nih.gov]

  […] revascularization is only useful when the patient shows concomitant coronary atherosclerosis on coronary angiogram. [ipfs.io]

• Chest Pain

  Chest pain generally occurs at rest and usually in the absence of flow-limiting coronary stenoses. [empendium.com]

  The patient was admitted to the coronary care unit where her ongoing anginal chest pain required escalation of therapy. [smj.org.sg]

  During coronary angiography, arterial spasm occurred associated with chest pain and ventricular ectopic beats. This was relieved by the acute administration of sublingual nitrates. [amjmed.com]

  If you have any type of chest pain, you should contact your healthcare provider. They are likely to run tests to see what’s causing the pain. If you have severe chest pain, go to the emergency room or call 911. This can be an emergency. [my.clevelandclinic.org]

• Heart Disease

  Some examples of cardiovascular diseases include ischemic heart disease, heart valve disease, cardiomyopathies, peripheral artery disease, congenital heart disease, and vascular disease of the kidneys. This study is located in Bethesda, Maryland. [nhlbi.nih.gov]

  Continue reading → Tags: cardiac syndrome X, coronary artery obstruction, coronary microvascular disease, diagnosing heart disease in women, heart attack symptoms, ischemic heart disease, microvascular disease, MVD, non-obstructive heart disease, prinzmetal's [myheartsisters.org]

  Signs and Symptoms of Coronary Heart Disease This web page presents an overview of coronary heart disease, explaining angina as the most frequent symptom of coronary heart disease. Medication vs. [pacificmedicaltraining.com]

  Angina is a symptom of coronary artery disease (CAD), the most common heart disease. CAD happens when a sticky substance called plaque builds up in the arteries that supply blood to the heart, reducing blood flow. [medlineplus.gov]

  Family history of heart disease. Tell your health care provider if your mother, father or any siblings have or had heart disease or a heart attack. Tobacco use. [mayoclinic.org]

• Retrosternal Chest Pain

  Fifteen minutes after a renal arteriogram (May 7) was performed, the patient had severe retrosternal chest pain associated with hypotension and bradycardia. Serial ECGs are depicted [jamanetwork.com]

  Ahmed, MD, Iowa Heart Center, Jennie Edmundson Hospital, Council Bluffs, Iowa Typical anginal symptoms are characterized by recurrent attacks of retrosternal chest pain brought on by effort and emotion, and relieved by rest or by the administration of [cathlabdigest.com]

• Shoulder Pain

  Angina may be more difficult to identify in some elderly people when they have symptoms such as abdominal pain after eating (due to increased blood demand for digestion) or have back or shoulder pain (which may be attributed to arthritis). [labtestsonline.org]

Further workup revealed metastatic pheochromocytoma. Conclusion Calcium channel blockers and nitrates which promotes coronary vasodilatation are commonly used in management of prinzmetal angina. [onlinejacc.org]

Hence, the coronary angiography is usually part of the workup of these patients and can help to guide the treatment4,6. Treatment Nitrates and calcium channel blockers are the main treatments for patients with variant angina. [scielo.br]

Coronary angiography is usually part of the workup of these patients and can help orient treatment [2]. 2. [hindawi.com]

• ST Elevation

  The mean daily number of ST elevation in group 1 was similar to that in group 2 (4.8 +/- 5.1 vs 4.1 +/- 4.6; p = not significant). [ncbi.nlm.nih.gov]

  Although variant angina may progress on to ST elevation myocardial infarction, the former is distinguished by a history of recurrent chest pain and prompt response to nitrates. [escardio.org]

  Associated with reversible ST elevations on ECG. Does not cause an increase in serum concentrations of cardiac biomarkers. [youtube.com]

  Single channel Holter recording during syncope showing normal ST segment (1) and ST segment elevation (2); during ST segment elevation severe ventricular arrhythmias were detected (transient ventricular tachycardia and fibrillation). [tandfonline.com]

  ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall I21.1 ST elevation (STEMI) myocardial infarction of inferior wall I21.11 ST elevation (STEMI) myocardial infarction involving right coronary artery I21.19 ST [icd10data.com]

• T Wave Inversion

  Once again, ECGs demonstrated T-wave inversion in V1–3. A repeat test showed that cTnI level was elevated at 0.4 ng/L. [smj.org.sg]

  wave inversion or flattening from previous MI Exercise ECG Thallium test Coronary angiography Exclude precipitating factors – anaemia, diabetes, hyperlipidaemia, thyrotoxicosis, GCA Management Change lifestyle Treat modifiable risk factors – hypertension [medicalnotesonline.blogspot.com]

  Miwa K, Kambara H, Kawai C, Murakami T. Two electrocardiographic patterns with or without transient T-wave inversion during recovery periods of variant anginal attacks. Jpn Circ J. 1983 Dec. 47(12):1415-22. [Medline]. [emedicine.com]

• Ischemic Changes

  In the rest 201Tl study, septal perfusion was low on the early image, although partial redistribution of this site was observed on the delayed image without the appearance of chest pain or electrocardiographic ischemic change. [ncbi.nlm.nih.gov]

  They also demonstrate the importance of Holter monitoring (of 24–48 h) or loop recorders (depending on the frequency of symptoms) illustrating both ischemic changes and the ventricular arrhythmias caused by this ischemic environment. [tandfonline.com]

  ischemic and non-ischemic heart disease. [journalofcardiologycases.com]

  The original definition of cardiac syndrome X also mandated that ischemic changes on exercise (despite normal coronary arteries) were displayed, as shown on cardiac stress tests.[9] The primary cause of cardiac syndrome X is unknown, but factors apparently [en.wikipedia.org]

Treatment Top Medical Treatment 1. Modification of risk factors, particularly smoking cessation. 2. Low-dose acetylsalicylic acid (ASA). 3. [empendium.com]

The frequency of anginal attacks and the consumption of sublingual nitroglycerin tablets decreased significantly in both treatment periods in comparison with those in the observation period before treatment, but in the observation period after treatment [ncbi.nlm.nih.gov]

Drugs such as calcium antagonists and nitrates are the mainstays of treatment. The spasms tend to come in cycles – appearing for a time, then going away. After six to 12 months of treatment, doctors may gradually reduce the medication. [heart.org]

CONCLUSIONS: Although the prognosis of multivessel spasm is believed to be poor, this may not necessarily be so. [ncbi.nlm.nih.gov]

However, in absence of significant coronary stenoses, and if appropriately treated, it is generally associated with a favorable long-term prognosis [ ]. [internationaljournalofcardiology.com]

Outlook / Prognosis What can I expect if I have Prinzmetal angina? The outlook (prognosis) for someone with Prinzmetal angina is generally good. You’ll still need long-term care and follow-up appointments with experienced cardiologists. [my.clevelandclinic.org]

[13] The prognosis of vasospastic angina depends on the extent of underlying coronary artery disease (CAD). [wikidoc.org]

J Cardiol Cases 2012, 6:e161-162. 9.Long-term prognosis for patients with variant angina and influential factors. [escardio.org]

Conventional therapy including nitrates, beta blockers, and surgical bypass has proved to be generally unsatisfactory in patients with variant angina of suspected vasospastic etiology. [ncbi.nlm.nih.gov]

Clinical and arteriographic features of Prinzmetal’s variant angina: Documentation of etiologic factors.Am. J. Cardiol. 1976; 37: 831-839 Unverdorben M. Haag M. Fuerste T. Weber H. Vallbracht C. [internationaljournalofcardiology.com]

Description : • Angina caused by transient coronary spasms (usually occurring close to areas of coronary stenosis) • Unrelated to exertion and may even occur at rest (classically at night) Etiology : e.g., cigarette smoking, use of stimulants (e.g., cocaine [youtube.com]

This case highlights the mortality associated with prinzmetal angina and the importance of recognizing the underlying etiology. 1. [hindawi.com]

[…] cigarette smoking, use of stimulants (e.g., cocaine, amphetamines) or sumatriptan, alcohol, stress, hyperventilation, exposure to cold • There is an association with other disorders involving vasospasms (e.g., Raynaud phenomenon, migraine headaches) Epidemiology [youtube.com]

This review describes the epidemiology, pathogenesis, clinical spectrum, and management of variant angina, as well as outcomes in patients who present with aborted sudden cardiac death (ASCD). [ncbi.nlm.nih.gov]

The epidemiology of migraine. Am J Med. 2005;118(Suppl 1):S3-S10. 2. Kurth T, Gaziano JM, Cook NR, Logroscino G, Diener HC, Buring JE. Migraine and risk of cardiovascular disease in women. JAMA. 2006;296:283-91. Medline 3. [revespcardiol.org]

Epidemiology Vasospastic angina represents about 2.0% of hospital admissions with a clinical pattern of unstable angina. It most frequently appears in the adult age (50 to 60 years) and shows a 5:1 ratio in male:female prevalence. [escardio.org]

An epidemiologic review. Headache. 2004 May. 44 Suppl 1:S5-12. [Medline]. Hirano Y, Uehara H, Nakamura H, et al. [emedicine.com]

It is now known that variant angina is the result of transient coronary artery spasm at the site of an atherosclerotic plaque.[1] The pathophysiologic effect of coronary spasm is the rapid development of transmural myocardial ischemia resulting in ST-segment [medscape.com]

Until the pathophysiology of this syndrome is clarified, however, the associated risks and the results to be expected from surgical therapy are unknown. FULL TEXT [annals.org]

With better understanding of the interactions between inflammation, endothelium, and smooth muscle cells, we and other investigators have provided new insights into the basic pathophysiology of CVsA. [ncbi.nlm.nih.gov]

Cardiac rehabilitation programs have also been The section on pathophysiology begins with a established to facilitate the return to function of chapter by Greenfield and Rembert discussing patients who have had acute coronary insuffi the factors that [books.google.com]

Coronary vasospasm may be directly prevented by a general inhibition of smooth muscle contraction by the calcium antagonist. [ncbi.nlm.nih.gov]

Can angina pectoris be prevented? Maintaining a healthy lifestyle can help to delay or prevent angina pectoris. [hopkinsmedicine.org]