Prinzmetal's angina, also known as variant angina or angina inversa, is a syndrome typically consisting of angina (cardiac chest pain) at rest that occurs in cycles. It is caused by vasospasm, a narrowing of the coronary arteries caused by contraction of the smooth muscle tissue in the vessel walls rather than by atherosclerosis (buildup of fatty plaque and hardening of the arteries). It was first described in 1959 by the American cardiologist Dr Myron Prinzmetal (1908-1987). The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... angina tonsillaris see tonsillitis. ... Vasospasm refers to a condition in which blood vessels spasm, leading to constriction. ... The coronary circulation consists of the blood vessels that supply blood to, and remove blood from, the heart. ...

Features

Symptoms typically occur at rest, rather than on exertion. 2/3 of patients have concurrent atherosclerosis of a major coronary artery, but this is often mild or not in proportion to the degree of symptoms. The coronary circulation consists of the blood vessels that supply blood to, and remove blood from, the heart. ...

It is associated with specific ECG changes (elevation rather than depression of the ST segment) ECG may also refer to the East Coast Greenway Lead II An Electrocardiogram (ECG or EKG, abbreviated from the German Elektrokardiogramm) is a graphic produced by an electrocardiograph, which records the electrical voltage in the heart in the form of a continuous strip graph. ...

Diagnosis

Patients who develop cardiac chest pain are generally treated empirically as an "acute coronary syndrome", and are generally tested for cardiac enzymes such as creatine kinase isoenzymes or troponin I or T. These may show a degree of positivity, as coronary spasm too can cause myocardial damage. Echocardiography or thallium scintigraphy is often performed. angina tonsillaris see tonsillitis. ... Creatine Kinase Creatine kinase (CK), also known as phosphocreatine kinase or creatine phosphokinase (CPK) is an enzyme (EC 2. ... Troponin is a protein complex that confers calcium sensitivity to muscle cells. ... An echocardiogram. ...

The gold standard is coronary angiography with injection of provocative agents into the coronary artery. Rarely, an active spasm can be documented angiographically (e.g. if the patient receives an angiogram with intent of performing a primary coronary intervention with angioplasty). Depending on the local protocol, provocation testing may involve substances such as ergonovine, methylergonovine or acetylcholine. Exaggerated spasm is diagnostic of Prinzmetal angina. In medicine, a gold standard test is the diagnostic test that is regarded as definitive in determining whether an individual has a disease process. ... A coronary catheterization is a minimally invasive procedure to access the coronary circulation and blood filled chambers of the heart using a catheter. ... Angioplasty is the mechanical, hydraulic dilation of an artery lumen which has been narrowed, sometimes totally obstructed, generally due to atheroma (the lesion of atherosclerosis). ... Ergonovine, also known as ergometrine, d-lysergic acid beta-propanolamide, is one of primary ergot alkaloids and an alkaloid of many species of morning glory, too. ... Methylergonovine, also known as methylergometrine, methylergobasin, and d-lysergic acid 1-butanolamide, is a synthetic analogue of ergonovine, a psychedelic alkaloid found in ergot, and many species of morning glory. ... The chemical compound acetylcholine, often abbreviated as ACh, was the first neurotransmitter to be identified. ...

Treatment

Prinzmetal angina typically responds to the same treatments as other forms of angina, although nitrates and calcium channel blockers are relatively more effective. In inorganic chemistry, nitrates are the salts of nitric acid. ... Calcium channel blockers are a class of drugs with effects on the muscle of the heart and the muscles of the rest of the body. ...

Reference

• Prinzmetal M, Kennamer R, Merliss R. A variant form of angina pectoris. Am J Med 1959;27:375-88. PMID 14434946.

External links

• Emedicine article
• Whonamedit.com article