Prinzmetal Angina Pectoris
Angina pectoris is a clinical syndrome in which the patient describes retrosternal, paroxysmal pain, with variable intensity. Pain is actually an expression of biological realities, namely the temporary deprivation of oxygen to the myocardium.
Prinzmetal angina pectoris (vasospastic angina or angina spontaneously, as it is called) is a special form of angina where ischemia is due to acute coronary spasm that determines through sudden contraction, brutal reduction of oxygen intake to the myocardium (unlike classic angina where there is a discrepancy between the need for increased myocardial oxygen and supply oxygen from concrete). The spasm can occur in normal arteries (in fact, apparently normal because they do not work properly) or artery calcification presenting more or less advanced due to atherosclerosis. Such spasm can be dangerous if prolonged, can cause ventricular arrhythmias or myocardial infarction.
The pain out of vasospastic angina is the same as appeared in angina of effort both in terms of location and irradiation. What is typical for Prinzmetal angina is its spontaneous appearance at rest, during sleep (mostly in the morning) or in the course of ordinary activities that do not involve a request from the patient, pointing out an otherwise good exercise tolerance. The pain is intense, accompanied by anxiety, throbbing headache, palpitations, pallor, sweating, and faintness conditions. Phase progression of pain is equal to the regression; unlike the conventional angina phase, progression is longer. Angina attacks almost always occur at fixed times. Factors that can trigger seizures are: alcohol, smoking, drugs, strong emotions, exposing the body to cold, medication that causes vasoconstriction.
The goal of the treatment is to control the pain and prevent a possible heart attack, by relaxing the smooth muscle and coronary vasodilation will improve myocardial oxygen intake. Nitroglycerin is effective in angina Prinzmetal as a vasodilator. Also, calcium blockers are effective as muscle relaxants, and may be associated with nitrates, and may even join two calcium blockers in different subclasses (dihydropyridine and verapamil or diltiazem).
Risk factors are age, obesity, smoking, sedentary lifestyle, prolonged exposure to stress, however, the major implication is the presence of conditions such as hypertension, diabetes, and hypercholesterolemia.