Prinzmetal angina
There is so little information around about Prinzmetal's and having that diagnosis can feel like a lonely place - Rebecca, From the Heart 999
image by: Non-Obstructive CAD: Coronary Microvascular Dysfunction & Spasms
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The Beginning - Part 1
So where to begin, well the beginning is probably the best place – cue wavy lines and hazing out as we jump back in time.
Before July 2014 I was what some might call a type A personality, I can hear my husband laughing and muttering ‘you still are’ under his breath. I was a highly ambitious executive spending the majority of my career working for FTSE 100 companies. My working days were usually between 10 -15 hours long not including a couple of hour commute into the city. My spare time consisted of working on my PhD and occasionally seeing my husband and my 3 step children. I had a Margret Thatcher philosophy of only sleeping for between 4-5 hours a night.
So what happened?…
Resources
A day in the life of living with Prinzmetal angina
Rebecca lives with Ehlers Danlos Syndrome type 3, which also led to Prinzmetal angina. In this post, she has written all about what it’s like on a daily basis living with a long-term condition.
Current Concepts in Coronary Artery Spasm
Coronary artery spasm is an abnormality of coronary vascular smooth muscle contraction that is associated with significant morbidity and mortality. The underlying pathophysiological process has remained unclear since Myron Prinzmetal described it in 1959. This article reviews current literature of the pathogenesis and outlines clinical features, diagnosis, and treatment options.
Variant Angina: Why do you Ignore Spasm of Coronary Arteries?
As described in introduction, I cannot understand why many cardiologists have no concern to coronary vasospasm. However, variant angina, even in the absence of coronary narrowing on angiography, can cause acute myocardial infarction and fatal arrhythmias. Cardiologists must study more on this serious disease and establish better method of treatment of patients with vasospasm.
Understanding Prinzmetal Angina
Sometimes, however, a cardiac catheterization with “provocative testing” is necessary to make the diagnosis. Because Prinzmetal angina is caused by coronary artery spasm rather than by a fixed blockage in the artery, the catheterization usually shows “normal” coronary arteries.
Unraveling The Mysteries of Prinzmetal’s Angina: What Is It And How Do We Diagnose It?
It is important to note that, although ST elevation would be diagnostic, it is frequently not observed in cases of coronary artery spasm. Rather, the diagnosis of coronary artery spasm should be suspected based on the timing of chest pain and the presence of syncope, arrhythmia or cardiac arrest.
Variant Angina
In 1959 Prinzmetal et al described 32 cases of angina occurring at rest, reporting that the clinical characteristics of these patients differed to those with Heberden’s classical angina of effort since: The angina did not occur with exertion and exercise - stress tests were typically negative. During pain, ST segment elevation rather than depression occurred. The angina episodes often recurred at the same time, frequently awaking the patient from sleep. The episodes may be associated with arrhythmias or progress on to myocardial infarction. Considering these differences, Prinzmetal coined the term "variant angina" and speculated that the condition was due to an "increased coronary tonus" or vasospasm.
Why Having a Chronic Condition Makes You Rethink Your Daily Routine
My heart issues also affect my sleep. As I lay awake in bed with severe angina pain, I wonder if I should wake my husband to get him to call an ambulance and face the inevitable. The explaining Prinzmetal’s angina to doctors who stand over you and say, “This is fascinating. I have only read about these cases.” The poking and prodding with needles of someone trying to cannulate me. You see, my veins don’t respond like everyone else’s. They close up, disappear, rupture, spasm; they will seemingly do anything to prevent cannulation.
The Beginning - Part 1
So where to begin, well the beginning is probably the best place – cue wavy lines and hazing out as we jump back in time. Before July 2014 I was what some might call a type A personality, I can hear my husband laughing and muttering ‘you still are’ under his breath. I was a highly ambitious executive spending the majority of my career working for FTSE 100 companies.
5 Things You Should Know About Coronary Spasm
Chest pain is a common symptom of coronary artery disease. However, people without fixed, severe coronary blockages also can have chest pain due to a rare condition called coronary spasm. While the number of people with coronary spasm is very small, the disorder is often misdiagnosed or not diagnosed at all.
Prinzmetal.org
The American Prinzmetal's Angina Association, Inc. has been formed to foster awareness about this little known but devastating heart disease.
From the Heart 999
From the Heart 999 is primarily a blog about living with a rare condition called Ehlers Danlos Syndrome (EDS) which for me results in a rare form of angina called Prinzmetal's. Although there are many names for this condition including vasospastic angina, variant angina and coronary artery spasms...
StatPearls
The cause of Prinzmetal Angina is a diffuse or segmental spasm in the coronary arteries which generate a decrease in blood supply to the myocardium generating chest pain. The coronary arteries may spasm as a result of exposure to cold weather, exercise, or a substance that promotes vasoconstriction such as alpha-agonists (pseudoephedrine and oxymetazoline). The use of recreation drugs such as cocaine has also been associated with the development of vasospastic angina, especially when associated the use of cigarettes.
Cardiac Health
Episodes of chest pain caused by Prinzmetal's angina usually occur in clusters, with periods of frequent episodes lasting for a few months followed by weeks or months with no chest pain episodes. The pain usually occurs between midnight and approximately 8:00 AM. Prinzmetal's angina may be brought on by hyperventilation, exposure to cold, or extreme emotional stress.
Patient
There is no specific cure. Managing lifestyle factors is important in prevention. Smoking, alcohol, and high levels of anxiety have a significant role in coronary spasm.
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