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Prinzmetal Angina Overview

written by: Emma Lloyd • edited by: Emma Lloyd • updated: 6/26/2010

Prinzmetal angina is an angina variant which is caused by contraction of smooth muscle tissue in the arteries rather than atherosclerosis.

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    What is Prinzmetal Angina?

    Prinzmetal angina (first described by American cardiologist Dr. Myron Prinzmetal in 1959) is a variant form of angina which has a different cause and a different pattern of occurrence than angina pectoris.

    Also known as variant angina or Prinzmetal syndrome, this type of angina is present in up to 10% of angina patients. Unlike other types of angina, Prinzmetal angina can occur in people with no coronary artery occlusion. Whether coronary occlusion is present or not, the angina is caused by spasms that cause the arteries to constrict, restricting the flow of blood to the heart.

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    Symptoms and Diagnosis of Prinzmetal Syndrome

    Unlike angina pectoris, Prinzmetal angina is more likely to occur at rest rather than after exertion, and attacks of Prinzmetal angina typically occur at night. Also in contrast to angina pectoris, people with Prinzmetal angina aren’t more likely to have an attack during periods of stress.

    Prinzmetal syndrome symptoms manifest as an uncomfortable feeling of pressure, squeezing, or pain in the middle of the chest. In some cases the pain may radiate to the arms, back, jaw, or neck. These symptoms are caused by reduced flow of blood (and lack of oxygen) to the heart.

    Many people with Prinzmetal syndrome also have a tendency to suffer from migraines, and some also develop Reynaud’s syndrome (vasoconstriction of fingers and toes).

    Diagnosis of Prinzmetal angina can sometimes be problematic, as cardiologists who rule out typical angina may overlook Prinzmetal syndrome due to the difference in symptom patterns. Accurate diagnosis is usually made on the basis of echocardiogram and angiogram results.

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    Prinzmetal Angina Treatment

    Typical treatment for Prinzmetal angina includes one or more medications to force the blood vessels to dilate and increase the flow of the blood to the heart during an angina attack. In addition, medication can reduce the frequency of painful angina attacks. The medications most often used to treat angina are nitrates, usually in the form of nitroglycerin. Calcium channel blockers, which dilate blood vessels and lower blood pressure, may also be prescribed.