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Recurrent syncope driven by unique-variant angina pectoris.

Guang Yang1, Yanna Lei1, Minglong Xin1

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Clinical Case Reports
|February 5, 2024
PubMed
Summary

Vasospastic variant angina can cause syncope and silent ischemic episodes. Diagnosis requires repeated 24-hour ECGs, coronary angiography, and spasm tests for effective management.

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Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • Vasospastic variant angina (VSA) is a clinical syndrome characterized by myocardial ischemia due to transient coronary artery vasospasm.
  • VSA can present with diverse symptoms, including chest pain, dyspnea, and syncope, often occurring at rest.

Observation:

  • The patient presented with syncope, a potentially serious manifestation of VSA.
  • Ischemic episodes were asymptomatic, highlighting the challenge in early detection.
  • Diagnostic workup involved serial 24-hour dynamic electrocardiogram (ECG) monitoring and coronary angiography.

Findings:

  • Coronary provocation spasm tests were crucial in confirming the diagnosis of VSA.
  • The combination of imaging and functional testing identified the underlying vasospastic mechanism.
  • Management strategies were tailored based on the confirmed diagnosis and severity of vasospasm.

Implications:

  • Accurate diagnosis of VSA is essential for preventing adverse cardiovascular events.
  • Multimodal diagnostic approaches are vital for identifying VSA, especially in atypical presentations.
  • Effective management of VSA can significantly improve patient outcomes and quality of life.