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Coronary Vasospasm (Variant Angina)

Angina caused by transient coronary artery spasm, occurring at rest.

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kardiyoloji department. Book Appointment →

What is Coronary Vasospasm (Variant Angina)?

Coronary vasospasm is a transient, severe contraction of coronary arterial smooth muscle that narrows the lumen and causes myocardial ischemia. It is also known as variant angina or Prinzmetal angina.

Unlike classic atherosclerotic coronary disease, spasm can occur in normal or minimally atherosclerotic arteries. It usually occurs at rest, most commonly between midnight and early morning.

Transient ST-segment elevation on the ECG is characteristic. Provocative testing (acetylcholine or ergonovine) may be used for diagnosis. Smoking is the most important modifiable risk factor.

Calcium channel blockers are the cornerstone of therapy; nitrates are used as adjuncts. Beta-blockers may worsen vasospasm and are generally contraindicated.

Symptoms

Chest pain at rest, typically at night or early morning
Pain radiating to the arm, neck or jaw
Sweating and nausea during pain
Palpitations and arrhythmia during spasm
Presyncope
Pain often resolves spontaneously or with nitroglycerin

Risk Factors

Smoking (strongest risk factor)
Cocaine and amphetamine use
Cold exposure and hyperventilation
Magnesium deficiency
Young age (40–50 years most common)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Chest pain at rest (requires urgent evaluation)
  • Recurrent nocturnal angina
  • Pain relieved by nitroglycerin that keeps recurring

Treatment Methods

01
Calcium channel blockers (diltiazem, amlodipine, nifedipine) as cornerstone therapy
02
Long-acting nitrates (isosorbide mononitrate)
03
Smoking cessation
04
Avoidance of beta-blockers
05
Magnesium supplementation when low
06
Consideration of coronary stenting or surgery in refractory cases

Which Department to Visit?

You can visit our Kardiyoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.