Prinzmetal variant angina (Smarty PANCE)

What is Prinzmetal or variant angina?

A clinical entity characterized by episodes of rest angina that promptly respond to short-acting nitrates and are attributable to coronary artery vasospasm

What is the new accepted name for Prinzmetal or variant angina?

Vasospastic angina was previously referred to as Prinzmetal or variant angina

Symptoms of Prinzmetal variant angina?

Symptoms are anginal discomfort occurring mainly during rest, often at night or early morning, and only rarely and inconsistently during exertion

What two factors of Prinzmetal angina should help you distinguish it from classical angina?

The quality of the chest pain is indistinguishable from classical angina associated with obstructive CAD; however, the context in which it occurs differs. Patients with vasospastic angina report that their episodes are predominantly at rest and that many occur from midnight to early morning

What is the #1 risk factor for Prinzmetal variant angina?

Cigarette smoking is the #1 risk factor, substance abuse is an important risk factor often cocaine

What is the gold standard diagnostic test for Prinzmetal variant angina?

The gold standard is coronary angiography with the injection of provocative agents (ergonovine or acetylcholine) into the coronary artery.

What is used for the acute treatment of vasospastic angina?

Usually, sublingual nitroglycerin promptly relieves variant angina.

What is used to prevent symptoms of vasospastic angina?

Calcium channel blockers may effectively prevent symptoms.

Drugs to avoid in vasospastic angina?

Nonselective beta blockers, such as propranolol can exacerbate vasospasm and should be avoided