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Variant angina differs from stable angina in that it commonly occurs in individuals who are at rest or even asleep, whereas stable angina is generally triggered by exertion or intense exercise. Variant angina is caused by vasospasm, a narrowing of the coronary arteries due to contraction of the heart's smooth muscle tissue in the vessel walls. [3]
Coronary vasospasm classically produces chest pain at rest, also known as variant angina (vasospastic angina or Prinzmetal's angina). [5] Chest pain is more common at certain times of the day, usually from late night to early morning. [6] These episodes can be accompanied by nausea, vomiting, cold sweating, and even syncope.
Some studies have found an increased risk of other vasospastic disorders in cardiac microvascular angina patients, such as migraine and Raynaud's phenomenon. Treatment typically involves beta-blockers, such as metoprolol, however beta blockers can make coronary spasms worse. [4] Microvascular angina is a separate condition from variant angina.
Also known as 'effort angina', this refers to the classic type of angina related to myocardial ischemia.A typical presentation of stable angina is that of chest discomfort and associated symptoms precipitated by some activity (running, walking, etc.) with minimal or non-existent symptoms at rest or after administration of sublingual nitroglycerin. [11]
The most common symptom is chest pain or discomfort that occurs regularly with activity, after eating, or at other predictable times; this phenomenon is termed stable angina and is associated with narrowing of the arteries of the heart. Angina also includes chest tightness, heaviness, pressure, numbness, fullness, or squeezing. [28]
Cardiac ischemia may be asymptomatic or may cause chest pain, known as angina pectoris. It occurs when the heart muscle, or myocardium , receives insufficient blood flow. [ 10 ] This most frequently results from atherosclerosis , which is the long-term accumulation of cholesterol-rich plaques in the coronary arteries .
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Amlodipine, sold under the brand name Norvasc among others, is a calcium channel blocker medication used to treat high blood pressure, coronary artery disease (CAD) [10] and variant angina (also called Prinzmetal angina or coronary artery vasospasm, among other names). [11] It is taken orally (swallowed by mouth). [10]