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Prinzmetal's angina.

Kathryn Buchanan Keller1, Louis Lemberg

  • 1Florida Atlantic University Christine E. Lynn College of Nursing, Boca Raton, Florida, USA.

American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses
|August 6, 2004
PubMed
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Prinzmetal's angina (PVA) involves temporary coronary vasospasm, often affecting younger women. Diagnosis relies on ST-segment elevation during angina, with ergonovine testing being most effective.

Area of Science:

  • Cardiology
  • Vascular Medicine

Background:

  • Prinzmetal's angina (PVA), or variant angina, is characterized by temporary coronary vasospasm leading to reduced blood flow.
  • It predominantly affects younger women, often without traditional cardiovascular risk factors, but is linked to smoking and other vasospastic disorders.

Observation:

  • PVA is associated with arrhythmias and endothelial dysfunction.
  • Diagnosis involves observing transient ST-segment elevation during angina episodes.
  • Ergonovine administration is the most sensitive and specific diagnostic test, while exercise stress tests are not valuable.

Findings:

  • Coronary vasospasm is the primary mechanism, causing a transient reduction in luminal diameter.
  • Nitroglycerin effectively reverses ergonovine-induced vasospasm.

Related Experiment Videos

  • Medical therapy includes vasodilators like nitrates and calcium channel blockers.

    • Implications:

    • Prognosis is generally good if significant coronary artery stenosis is absent.
    • In elderly patients with PVA and coronary atherosclerosis, treatment should address the underlying atherosclerosis.
    • Beta-blockers and high-dose aspirin are contraindicated in PVA management.