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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.
A variant form of angina—Prinzmetal's angina—occurs in patients with normal coronary arteries or insignificant atherosclerosis. It is believed caused by spasms of the artery. It occurs more in younger women. [23] Coital angina, also known as angina d'amour, is angina subsequent to sexual intercourse. [24]
ST segment depression and T-wave changes may be seen in patients with unstable angina; Depressed but upsloping ST segment generally rules out ischemia as a cause. Also, it can be a normal variant or artifacts, such as: Pseudo-ST-depression, which is a wandering baseline due to poor skin contact of the electrode [3]
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.
Unstable angina is a type of angina pectoris [1] that is irregular or more easily provoked. [2] It is classified as a type of acute coronary syndrome. [3]It can be difficult to distinguish unstable angina from non-ST elevation (non-Q wave) myocardial infarction.
The Kounis syndrome is distinguished from two other causes of coronary artery spasms and symptoms viz., the far more common, non-allergic syndrome, Prinzmetal's angina [4] and eosinophilic coronary periarteritis, an extremely rare disorder caused by extensive eosinophilic infiltration of the adventitia and periadventitia, i.e. the soft tissues ...
Moreover, that variability was caused by narrowing of the arteries in combination with vasomotor tone, but the two factors interacted in a different way than was observed in variant angina. In other studies, he demonstrated that vasoconstriction and thrombosis are jointly responsible for ischemic attacks in patients with acute myocardial ...