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Vasospastic Angina (Prinzmetal Angina)

Chest pain occurring at rest due to transient spasm of the epicardial coronary arteries.

Written by: Saygı Hospital Health Guide Editorial Board
Published:

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

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 Vasospastic Angina (Prinzmetal Angina)?

Vasospastic angina is caused by transient focal or diffuse spasm of the epicardial coronary arteries. Unlike classic effort angina, attacks tend to occur at rest — often at midnight or in the early morning hours. It may develop with or without underlying atherosclerotic plaque.

During spasm the ECG shows transient ST-segment elevation that resolves once the spasm subsides. Coronary angiography may demonstrate minimal or non-obstructive disease. Diagnosis is supported by provocation testing or typical clinical findings.

Prognosis is generally favorable; however, arrhythmias and myocardial infarction may develop during spasm, so treatment is important. Calcium channel blockers are the cornerstone of therapy.

Symptoms

Rest chest pain at night or in the early morning hours
Self-terminating pain lasting 5–15 minutes
Rapid response to nitroglycerin
Associated syncope and fainting
Palpitations and arrhythmia
Transient ST elevation on ECG during pain
Pain triggered by smoking

Risk Factors

Smoking
Stimulants such as cocaine and amphetamines
Chronic stress
Hyperventilation
Cold exposure
Alcohol withdrawal
East Asian ethnicity

When to See a Doctor?

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

  • Recurrent chest pain at rest
  • Nighttime pain responsive to nitroglycerin
  • Syncope or arrhythmia accompanying anginal episodes
  • Increasing frequency of pain in known disease

Treatment Methods

01
Calcium channel blockers (first-line therapy)
02
Long-acting nitrates
03
Smoking cessation and trigger avoidance
04
Avoidance of non-selective beta-blockers
05
Coronary angiography and ICD evaluation in refractory cases
06
Treatment of coexisting atherosclerotic disease

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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You can make an appointment with our specialists or contact us for your concerns.

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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.