Prinzmetal’s Angina

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Prinzmetal’s Angina, also known as variant angina, is a rare form of angina pectoris that differs from the more common stable angina. It is characterized by episodes of chest pain that occur at rest, often during the night or early morning hours. This type of angina is caused by a spasm in the coronary arteries, which temporarily reduces blood flow to the heart muscle. While the exact cause of Prinzmetal’s Angina is unknown, it is believed to be related to abnormal functioning of the smooth muscle cells in the walls of the coronary arteries.

Chest Pain: A Distinctive Symptom

The most prominent symptom of Prinzmetal’s Angina is chest pain, which can be severe and debilitating. Unlike stable angina, which is typically triggered by physical exertion or emotional stress, the chest pain associated with Prinzmetal’s Angina often occurs at rest. The pain is usually described as a squeezing or pressure-like sensation in the chest, and it may radiate to the left arm, shoulder, jaw, or back. The episodes of chest pain can last anywhere from a few minutes to several hours.

Shortness of Breath: A Sign of Impaired Oxygen Supply

Shortness of breath is another common symptom experienced by individuals with Prinzmetal’s Angina. The reduced blood flow to the heart muscle during a spasm can lead to an inadequate supply of oxygen, causing difficulty in breathing. This symptom may be particularly noticeable during episodes of chest pain and can be accompanied by a sense of tightness in the chest.

Sweating: A Response to Increased Sympathetic Activity

Excessive sweating, also known as diaphoresis, is a physiological response to increased sympathetic activity. During an episode of Prinzmetal’s Angina, the body’s sympathetic nervous system is activated, leading to an increase in heart rate and blood pressure. This heightened sympathetic response can result in profuse sweating, which is often described as cold and clammy.

Nausea and Vomiting: A Common Accompaniment

Many individuals with Prinzmetal’s Angina experience nausea and vomiting during episodes of chest pain. These symptoms are thought to be a result of the body’s response to the intense pain and stress associated with the condition. Nausea and vomiting can further contribute to the overall discomfort and distress experienced by individuals with Prinzmetal’s Angina.

Dizziness: A Result of Reduced Blood Flow to the Brain

Dizziness is a common symptom reported by individuals with Prinzmetal’s Angina. The reduced blood flow to the heart muscle during a spasm can also affect blood flow to the brain, leading to dizziness or lightheadedness. This symptom can be particularly concerning, as it may increase the risk of falls or accidents.

Palpitations: An Awareness of the Heartbeat

Palpitations, or an awareness of the heartbeat, can occur during episodes of Prinzmetal’s Angina. The abnormal functioning of the coronary arteries can disrupt the normal electrical signals in the heart, leading to irregular heart rhythms or palpitations. These palpitations may be felt as a rapid, pounding, or fluttering sensation in the chest.

Syncope: Fainting Spells

In severe cases, individuals with Prinzmetal’s Angina may experience syncope, or fainting spells. The reduced blood flow to the brain during a spasm can cause a sudden loss of consciousness. Syncope is a serious symptom that requires immediate medical attention, as it may indicate a more severe form of Prinzmetal’s Angina or an underlying heart condition.

Treatment and Management

While there is no cure for Prinzmetal’s Angina, the condition can be effectively managed with appropriate treatment. The primary goal of treatment is to relieve symptoms, prevent complications, and improve the overall quality of life for individuals with the condition.


Medications are commonly prescribed to manage Prinzmetal’s Angina. Calcium channel blockers, such as nifedipine or diltiazem, are often used to relax the smooth muscle cells in the coronary arteries, reducing the frequency and severity of spasms. Nitroglycerin, a vasodilator, may also be prescribed to relieve chest pain during an episode.

Lifestyle Modifications

Adopting a heart-healthy lifestyle can significantly improve the management of Prinzmetal’s Angina. This includes quitting smoking, maintaining a healthy weight, engaging in regular physical activity, and following a balanced diet low in saturated fats and cholesterol. Stress management techniques, such as relaxation exercises or meditation, may also be beneficial in reducing the frequency and intensity of episodes.

Monitoring and Follow-up

Regular monitoring and follow-up with a healthcare provider are essential for individuals with Prinzmetal’s Angina. This allows for the evaluation of treatment effectiveness, adjustment of medications if necessary, and identification of any potential complications. It is important to promptly report any changes in symptoms or the occurrence of new symptoms to ensure appropriate management.

In Conclusion

Prinzmetal’s Angina is a distinct form of angina pectoris characterized by episodes of chest pain at rest. The symptoms, including chest pain, shortness of breath, sweating, nausea, vomiting, dizziness, palpitations, and syncope, can significantly impact an individual’s quality of life. While there is no cure for Prinzmetal’s Angina, appropriate treatment and lifestyle modifications can effectively manage the condition and improve overall well-being. By understanding the symptoms and seeking timely medical attention, individuals with Prinzmetal’s Angina can lead fulfilling lives while minimizing the impact of the disease.

Haroon Rashid, MD
Rate author
Urgent Care Center of Arlington, VA
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