Prinzmetal’s variant angina is severe chest pain (angina) that occurs while a person is resting or sleeping. This condition is caused by a spasm in the coronary artery (which supplies blood to the heart muscle). The spasm temporarily narrows the artery cutting off the heart’s blood supply. About two-thirds of individuals with Prinzmetal’s angina also have plaque buildup (atherosclerosis) in their coronary arteries, but atherosclerosis is not thought to be the cause. Only about 2% of cases of angina are Prinzmetal but it happens more often in younger adults than other angina types.
Symptoms of an attack include nausea, fatigue, shortness of breath, sweating, and dizziness. Usually, there is also some pain in the chest, arms, neck, jaw, shoulders, or back. The pain is described as a pressure or squeezing feeling. Others describe it as though a large weight has been placed on their chest, or like indigestion. Individuals of Japanese descent seem to have a higher risk for the disease than others. The spasms may be brought on by cold weather, stress, certain medications, smoking or cocaine use. Spasms tend to come in cycles and then may disappear for a while only to return again.
Diagnosis can be challenging because it is often only diagnosed after other heart diseases have been ruled out. An electrocardiogram (EKG) can make a positive diagnosis, but only if the person is being monitored when the attack happens. Medication to control the spasms is the most common treatment. The condition is chronic (lifelong), but with treatment the outlook for a healthy life is good. Research is ongoing, so talk to your doctor about the most current treatment options. Support groups are also a good source of information and can help connect you with others affected by Prinzmetal’s variant angina.