The spectrum of coronary artery spasm. The variable variant

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H D Kirshenbaum, I S Ockene, J S Alpert

    JAMA
    |July 24, 1981
    PubMed

    Insights

    Coronary artery spasm, a common cause of angina, presents variably. Prompt recognition and treatment are crucial due to new therapies for this condition.

    Area of Science:

    • Cardiology
    • Internal Medicine

    Background:

    • Coronary artery spasm is a significant cause of angina.
    • Effective medical therapies are now available, necessitating prompt diagnosis.

    Observation:

    • Clinical presentation of coronary artery spasm is highly variable.
    • Symptoms can mimic unstable rest angina with ST-segment elevation or present as exertional or non-cardiac chest pain.
    • Electrocardiogram (ECG) findings may include ST-segment depression, not just elevation.

    Findings:

    • Prinzmetal's variant angina is often recognized, but other forms of coronary artery spasm can be misdiagnosed.
    • The syndrome can manifest as chronic stable angina, unstable angina, or atypical chest pain.
    • Case studies highlight the diverse clinical features of variant angina.

    Implications:

    • Physicians must be aware of the varied presentations of coronary artery spasm for accurate diagnosis.
    • Early identification and treatment of coronary artery spasm can improve patient outcomes.
    • Understanding the spectrum of variant angina is key to effective management.

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