- Prinzmetal's angina is caused by coronary artery spasms. In contrast to more common forms of angina, the attacks of Prinzmetal's are not related to physical activity, high blood pressure or increased heart rate.
- Chest pain is experienced while the patient is at rest, and can even occur while in bed. Pain usually lasts less than 30 minutes. An electrocardiogram (ECG) taken during a Prinzmetal's anginal attack will show elevation of the S-T segment, as opposed to the S-T depression that would be seen in an attack of typical angina.
- Prinzmetal's angina must be differentiated from typical angina, and all forms of angina must be differentiated from the pain of myocardial ischemia (MI, or heart attack). Typical anginal pain is brought on by exertion or stress; Prinzmetal's angina comes on at rest, and the patient is able to exercise normally when not having an attack. Anginal pain is episodic and temporary; the pain of an MI usually (though not always) persists and worsens. Both Prinzmetal's and typical angina respond promptly to treatment with vasodilators (see treatment section).
- Prinzmetal's angina is treated with vasodilators such as inhaled amyl nitrate and nitroglycerin tablets. The discomfort recedes swiftly with treatment.
- Prinzmetal's angina is not predictive of MI, but often coexists with obstructed coronary arteries and other signs of atherosclerosis. Patients with Prinzmetal's angina and coronary artery disease are at greater risk for MI.
- Anyone presenting with new chest pain, or with chest pain that feels different than their usual anginal attacks, should see a physician immediately. ECG and blood tests should be run to rule out MI. Angina patients should carry their vasodilators with them at all times. If anginal pain persists after taking vasodilators, contact a physician immediately.
