Prinzmetal's Angina: Definition & Causes

Instructor: Danielle Haak

Danielle has a PhD in Natural Resource Sciences and a MSc in Biological Sciences

Prinzmetal's angina is a rare type of angina caused by coronary artery spasms. In this lesson, we'll learn about the condition as well as the underlying causes leading to a coronary artery spasm.

What is Angina?

Steve woke up in the middle of the night, grasping at his chest. He couldn't believe how much pain he was suddenly experiencing. At 52, Steve was surprised he was experiencing chest pain -- wasn't he too young for this? He had been in a deep sleep, but the pain was so excruciating he had trouble catching his breath; there was no way he'd be able to fall back asleep.

Steve woke is wife up and told her what was happening. When she saw how much pain he was in, she decided they were taking a trip to the hospital immediately. The pain started to subside after about 20 minutes, but they agreed it was best for him to see a doctor as soon as possible.

Steve's doctor ran a number of tests and diagnosed him with angina, extreme chest pain caused by a disruption in oxygen-rich blood flow to the heart. After further investigation, Steve was diagnosed with Prinzmetal's angina. All of this terminology was new to him, so he began asking his doctor many questions.

Angina is chest pain caused by disrupted blood flow in the coronary arteries.
angina diagram

What is Prinzmetal's Angina?

Prinzmetal's angina is a form of unstable angina, meaning it usually occurs at rest, between the hours of midnight and early morning, and there's no predictable pattern to bouts of pain. (This is in contrast to stable angina, which is predictable pain caused by exercise or exertion.)

Prinzmetal's angina is rare, accounting for approximately 2% of all angina cases. It may also be referred to as variant angina, Prinzmetal's variant angina, or angina inversa. It's more common in men than in women, and it tends to affect younger patients than other forms of angina.

Causes of Prinzmetal's Angina

The name Prinzmetal comes from the researcher who discovered the underlying cause of this particular type of angina: coronary artery spasms. The coronary arteries are responsible for delivering oxygen-rich blood to the heart, and a coronary artery spasm is an involuntary constriction or tightening of the artery, limiting or completely blocking blood flow to the heart. When the heart is deprived of oxygen, it causes chest pain or angina.

Coronary artery spasms can be caused by:

  • exposure to cold temperatures
  • emotional stress
  • certain medications
  • smoking
  • cocaine use
  • hyperventilation

Many patients who suffer from coronary artery spasms also suffer from coronary artery disease, mainly characterized by atherosclerosis. Coronary artery disease is any disease affecting the coronary arteries, and atherosclerosis is the hardening of arteries due to the buildup of fatty deposits. These deposits narrow the artery and limit the body's natural release of nitric oxide, a chemical that helps keep blood vessels open and wide enough for blood to flow freely.

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