Prinzmetal Angina – symptoms, diagnosis, treatment
Typical angina is mainly due to narrowing of blood vessels that nourish the heart by fatty deposits inside lumen (plaque buildup). Prinzmetal angina is a particular form of angina that is due to a vasospasm in heart vessels (coronary). The vasospam is a sudden constriction of the vessel to cease for a short period of time the blood flow to heart muscle and that hurts because of this.
Is known about vasospastic Prinzmetal angina that usually occurs in younger people, that is not associated with risk factors like diabetes, but is closely related to smoking, nicotine easing spasms on coronary vessels (reduces nitric oxide release which is a dilator of coronary ).
Prinzmetal angina symptoms:
The main symptom of Prinzmetal angina is pain in the middle of the chest or heart area. Chest pain occurs at rest, not by effort (as in typical angina), usually begins in the second part of the night (scheduled) and takes up to 30 minutes.
Prinzmetal angina pain gives at the administration of sublingual nitroglycerin, and coronary spasms can be associated with spasms on other small arteries of the body. Can occur concurrently with angina: headaches (migraines) or Raynaud’s phenomenon.
Prinzmetal angina is not a neglected disease because of its possible complications such as syncope (episodes of loss of knowledge), arrhythmias (ventricular extrasystoles, ventricular tachycardia, ventricular fibrillation, sudden cardiac death, atrioventricular block).
In Prinzmetal angina diagnosis is established after history, physical examination by your cardiologist but also by the laboratory: ECG during pain, ECK Holter tests to cause coronary spasm with ergonovine, by hyperventilation, with acetylcholine.
Prinzmetal Angina – treatment:
Vasospastic angina treatment consists of a mandatory first step in stopping smoking.
To establish an effective and right treatment a consult to a cardiologist is necessary.
As medicine to treat Prinzmetal angina are indicated the nitrates (like nitroglycerin – to submission painful episode) and long-term treatment with calcium blockers, replaced with other classes of drugs only if the patient is non-responsive (with ACE inhibitors, antiarrhythmics). Beta-blockers are contraindicated as single therapy in Prinzmetal angina, but can be used in combination in patients with coronary significant lesions.
Treatment may last from one year to entire life depending on the reduction of spasms rates.