Presentation
[…] a peculiarity that we would like to highlight: A relapse occurred while on medical treatment and presenting a negative ergonovine test. [revespcardiol.org]
Abstract To study whether magnesium (Mg) deficiency is present in patients with variant angina, 24-hour Mg retention of low dose Mg (0.2 mEq/kg lean body weight) administered intravenously over 4 hours in 20 patients with variant angina was examined. [ncbi.nlm.nih.gov]
He had presented to an outside hospital with similar complaints. A cardiac catheterization performed at that time revealed normal coronaries. [onlinejacc.org]
Entire Body System
- Coronary Atherosclerosis
Such response could not be predicted by demographic factors, ECG changes, or degree of coronary atherosclerosis. [ncbi.nlm.nih.gov]
And in these cases without significant coronary atherosclerosis, prognosis was thought not so poor if they have optimal medical treatment. [omicsonline.org]
- Weakness
There is a weak relationship between severity of pain and degree of oxygen deprivation in the heart muscle (i.e. there can be severe pain with little or no risk of a heart attack, and a heart attack can occur without pain). [farezblog.blogspot.com]
You may also have shortness of breath, weakness, or fatigue. Nitroglycerin is the most common medicine to treat angina Managing angina includes treating high blood pressure and high blood cholesterol levels. [awomansview.com]
- Severe Pain
There is a weak relationship between severity of pain and degree of oxygen deprivation in the heart muscle (i.e. there can be severe pain with little or no risk of a heart attack, and a heart attack can occur without pain). [farezblog.blogspot.com]
Symptoms of Prinzmetal’s angina Symptoms of Prinzmetal’s angina include chest pain varying in severity, pain in the left side of your chest, chest tightness, and a feeling of constriction in the chest. [belmarrahealth.com]
After several events, you will learn what causes the pain to occur, what the pain feels like, and how long the pain usually lasts. To help learn your angina’s pattern and triggers, keep a log of when you feel pain. [nhlbi.nih.gov]
Clinical Presentation and Diagnosis of Vasospastic Angina Symptoms of vasospastic angina Patients experience very severe central chest pain, which is the same type of pain as classic angina. [lecturio.com]
There are several treatment options for these types of angina, ranging from medications alone to coronary bypass surgery in order to reduce the frequency or severity of your symptoms and to lower your risk of heart attack and death. [myheartsisters.org]
- Pallor
Some experience "autonomic symptoms" (related to increased activity of the autonomic nervous system) such as nausea, vomiting and pallor. [farezblog.blogspot.com]
Some experience "autonomic symptoms" (related to increased activity of the autonomic nervous system) such as nausea, vomiting, and pallor. [en.wikipedia.org]
Pallor, profuse perspiration, and other signs of shock are present. [7709192900.com]
- Surgical Procedure
Surgical procedures involving arterial bypass and angioplasty have become fairly common as a form of treatment of certain types of ischemic heart disease and resulting angina pectoris. [medical-dictionary.thefreedictionary.com]
Coronary Artery Bypass Grafting (CABG): This is a surgical procedure where a donor blood vessel from another site in the body is used to bypass area of stenosis. [healthengine.com.au]
They include lifestyle changes, medications, and surgical procedures when necessary. [labtestsonline.org]
They include trimetazidine, ivabradine, fasudil, and molsidomine.1,12 Surgical Procedures: Measures that restore conductive blood flow are recommended only if drug therapy fails. [uspharmacist.com]
Respiratoric
- Dyspnea
The patient reported to have chest pain the last couple of days associated with dyspnea. Her past medical history revealed familial adenomatous polyposis since 4 years and she has had a whipple surgery. [academic.oup.com]
Other associated symptoms may include nausea, diaphoresis, palpitations, dyspnea, and lightheadedness. [empendium.com]
Such chest “discomfort” may be accompanied by dyspnea, nausea, or sweating, and/or palpitations. These symptoms often persist for 15 minutes or more. [verywellhealth.com]
During each episode, symptoms of nausea, sweating, dizziness, dyspnea, and palpitations may be present. [wikidoc.org]
Gastrointestinal
- Pyrosis
Word Pyrosis Hindi Meaningअम्लपित्त, कलेजे की जलन, ह्रददाह a painful burning sensation in the chest caused by gastroesophageal reflux (backflow from the stomach irritating the esophagus); symptomatic of an ulcer or a diaphragmatic hernia or other disorder [studysite.org]
Cardiovascular
- Chest Pain
The base-line artifact was generated by the patient's rubbing of his chest because of chest pain. [nejm.org]
From Wikidata Jump to navigation Jump to search cardiac chest pain at rest that occurs in cycles variant angina angina inversa coronary vessel spasm Prinzmetal angina Prinzmetal's angina Prinzmetal's variant angina variant angina pectoris vasospastic [wikidata.org]
Another 23 subjects with incompletely explained chest pain given methacholine had neither ECG change nor spasm. [ncbi.nlm.nih.gov]
- Heart Disease
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]
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]
Join Us For A Heart Walk In Your Area Heart Walk is the American Heart Association's premiere event for raising funds to help save lives from heart disease and stroke. [heart.org]
Session Title: FIT Clinical Decision Making: Interventional Cardiology, Ischemic Heart Disease and Vascular Medicine Abstract Category: Acute and Stable Ischemic Heart Disease Presentation Number: 1108-157 2018 American College of Cardiology Foundation [onlinejacc.org]
Ischemic heart diseases Use Additional code to identify presence of hypertension ( I10-I16 ) Ischemic heart diseases I20 ICD-10-CM Diagnosis Code I20 Angina pectoris 2016 2017 2018 2019 Non-Billable/Non-Specific Code Type 1 Excludes angina pectoris with [icd10data.com]
- Tachycardia
The occlusive dysrhythmias included ventricular dysrhythmia (ventricular premature beats, ventricular tachycardia, slow ventricular tachycardia, ventricular fibrillation) in eight patients and conduction abnormalities (second- and third-degree AV block [ncbi.nlm.nih.gov]
Finally, he suffered another episode associated with sinus tachycardia with a 2:1 atrioventricular block (AVB), and nonsustained polymorphic ventricular tachycardia (Figure 2). Once again, it was controlled using intravenous nitro-glycerine. [revespcardiol.org]
Syncope is due to severe arrhythmias, including ventricular tachycardia, ventricular fibrillation, and high-degree atrioventricular block. Coronary artery spasm is the mechanism of ischemic episodes in variant angina. [jstage.jst.go.jp]
- Palpitations
Other associated symptoms may include nausea, diaphoresis, palpitations, dyspnea, and lightheadedness. [empendium.com]
Other sensations during episodes may include tightness or pressure in the chest, "heart burn," nausea, sweating, dizziness, and palpitations. Episodes tend to last around 5 to 15 minutes (longer in some cases), and tend to be similar to each other. [rarediseases.info.nih.gov]
She denied any prodromal symptoms of lightheadedness, nausea, and palpitations prior to the syncopal event. Furthermore, there were no signs or evidence of a post-ictal state. [hindawi.com]
[…] the overnight or early morning hours May spread to other parts of the body, such as the throat, arms, between the shoulder blades, or stomach (may feel like an ulcer or indigestion) Gives a feeling of tightness, pressure, or heaviness Nausea Sweating Palpitations—rapid [winchesterhospital.org]
Such chest “discomfort” may be accompanied by dyspnea, nausea, or sweating, and/or palpitations. These symptoms often persist for 15 minutes or more. [verywellhealth.com]
- Vascular Disease
A67-year-old woman with a history of arterial hypertension, peripheral vascular disease, and chronic atrial fibrillation presented with atypical chest pain for 1 year. [circ.ahajournals.org]
Kcentra was not studied in subjects who had a thromboembolic event, myocardial infarction, disseminated intravascular coagulation, cerebral vascular accident, transient ischemic attack, unstable angina pectoris, or severe peripheral vascular disease within [play.google.com]
Coronary Artery Disease Myocardial Ischemia Coronary Disease Angina Pectoris Angina Pectoris, Variant Heart Diseases Cardiovascular Diseases Arteriosclerosis Arterial Occlusive Diseases Vascular Diseases Chest Pain Pain Neurologic Manifestations Signs [clinicaltrials.gov]
2019 Billable/Specific Code cardiac I20.1 coronary I20.1 (artery) heart I20.1 Vasospasm (vasoconstriction) I73.9 ICD-10-CM Diagnosis Code I73.9 Peripheral vascular disease, unspecified 2016 2017 2018 2019 Billable/Specific Code Applicable To Intermittent [icd10data.com]
Skin
- Sweating
Pain may be accompanied by breathlessness, sweating and nausea in some cases. It usually lasts for about 3 to 5 minutes, and is relieved by rest or specific anti-angina medication. Chest pain lasting only a few seconds is normally not angina. [farezblog.blogspot.com]
It may make you sweat or lose your breath. The pain can strike your arm or neck, too. “Stable angina” comes on with exertion and then goes away easily. You can have this kind of angina for a long time. [livescience.com]
Other symptoms can include numbness or tingling, anxiety, fainting, dizziness, sweating, shortness of breath, pale skin, irregular heartbeat, nausea, or fatigue. To unlock this lesson you must be a Study.com Member. Create your account [study.com]
There are other diseases that can cause chest pain, abdominal pain, shortness of breath, sweating, and nausea and vomiting. Questions may be asked to determine whether other possibilities other than angina exist. [medicinenet.com]
Heart attack symptoms often include nausea or throwing up, weakness, tiredness or sweating. How long does angina last? Three to five minutes – up to 30 minutes Relieved by rest or medication Heart attacks generally last more than 30 minutes. [heartandstroke.ca]
Musculoskeletal
- 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]
Neurologic
- Stroke
Olympic sprinter shares his stroke story Learn the warning signs of stroke No bones about it: It’s time to fight heart disease with Best Friend Fridays The American Heart Association’s new effort looks to put pets in the workplace, while helping raise [heart.org]
It's not usually life threatening, but it's a warning sign that you could be at risk of a heart attack or stroke. With treatment and healthy lifestyle changes, it's possible to control angina and reduce the risk of these more serious problems. [nhs.uk]
It is known to cause a spectrum of cardiovascular manifestations including myocardial infarction, stroke, valvular abnormalities, as well as vascular and intracardiac thrombosis. [journals.lww.com]
Join Heart & Stroke’s Community of Survivors or Care Supporters’ Community support groups. Sign up for the Heart & Stroke recovery newsletter. [heartandstroke.ca]
- Dizziness
Notably, the patient had consulted her general practitioner 2 weeks before her presentation in the emergency department, because of dizziness, pre-syncope and chest pain symptoms. [academic.oup.com]
Other symptoms can include numbness or tingling, anxiety, fainting, dizziness, sweating, shortness of breath, pale skin, irregular heartbeat, nausea, or fatigue. To unlock this lesson you must be a Study.com Member. Create your account [study.com]
Bellyache पेट में पीड़ा, There were no technicians with the latest equipment waiting to help him decipher the coughs, bellyaches, chest pains, dizzy spells and fevers that ailed his... [studysite.org]
Workup
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]
QT, RR, ST Intervals
- 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]
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]
He was started on isosorbide mononitrate and ranolazine but he continued to have nocturnal chest pain with ST elevations and 3 rd degree heart block. Diltiazem and cilostazol were added. [onlinejacc.org]
[…] electrocardiography (ECG) findings consistent with ST elevation. [journalofcardiologycases.com]
Rhythm
- Ventricular Bigeminy
No arrhythmias were observed during ST segment depression, but 26 episodes of ST segment elevation (19%) were associated with arrhythmias: 7 with premature ventricular contractions, 3 with ventricular bigeminy, 3 with complete atrioventricular (AV) block [ncbi.nlm.nih.gov]
T Wave
- T Wave Inversion
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]
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]
Figure 9: EKG at that time showed long QTc (505 ms), Q wave and T wave inversion in leads III, aVF. View Figure 9. . [clinmedjournals.org]
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.medscape.com]
Other ECG Findings
- 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
In spite of intensifying the medical treatment, this situation took place two more times. [revespcardiol.org]
The consumption of sublingual nitroglycerin tablets decreased significantly in both treatment periods in comparison with the observation period before treatment (p less than 0.01, p less than 0.001, respectively). [ncbi.nlm.nih.gov]
Prognosis
Prognosis It is very difficult to predict the prognosis of patients with variant angina. Of course, subjects with critical narrowing, if they are not treated with percutaneous coronary interventions or bypass surgery, have more major cardiac events. [omicsonline.org]
CONCLUSIONS: Although the prognosis of multivessel spasm is believed to be poor, this may not necessarily be so. [ncbi.nlm.nih.gov]
Diffuse multi-vessel coronary artery spasm: Incidence and clinical prognosis. Int J Cardiol. July 31 2013; 167: 398-402 Kim W. Cho J.S. Hong Y.J. Ahn Y. Jeong M.H. [internationaljournalofcardiology.com]
Conclusions.: Although the prognosis of multivessel spasm is believed to be poor, this may not necessarily be so. [jacc.org]
Etiology
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]
This case highlights the mortality associated with prinzmetal angina and the importance of recognizing the underlying etiology. 1. [hindawi.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]
Epidemiology
[…] 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]
Epidemiological features of moyamoya disease in Japan: findings from a nationwide survey. Clin Neurol Neurosurg. 1997;99:S1–5. Article PubMed Google Scholar Graham J, Matoba A. A survey of moyamoya disease in Hawaii. [jmedicalcasereports.biomedcentral.com]
Epidemiology and the magnitude of coronary artery disease and acute coronary syndrome: a narrative review. J Epidemiol Glob Health. 2021;11(2):169-177. doi:10.2991/jegh.k.201217.001 Will JC, Yuan K, Ford E. [verywellhealth.com]
Pathophysiology
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]
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]
Prevention
Coronary vasospasm may be directly prevented by a general inhibition of smooth muscle contraction by the calcium antagonist. [ncbi.nlm.nih.gov]
Recent data, on the other hand, suggest that coronary angioplasty with stenting might help to prevent coronary spasm in refractory variant angina9. [escardio.org]
Calcium channel blockers are extremely effective in preventing coronary spasm. The long-acting nitrate, nicorandil, and Rho-kinase inhibitor are also useful for inhibiting coronary artery spasm. [jstage.jst.go.jp]