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Prinzmetal's variant angina (PVA) is characterized by recurrent episodes of chest pain (angina) that usually occur when a person is at rest, between midnight and early morning. "Typical" angina, by contrast, is often triggered by physical exertion or emotional stress. Episodes of PVA can be very painful, and may last from several minutes to thirty minutes. In some cases the pain may spread from the chest to the head, shoulder, or arm. The pain associated with PVA is caused by a spasm in the arteries that supply blood to the heart muscle (coronary arteries). This results in an obstruction of blood flow. In some people, persistent spasms increase the risk for serious complications such as a life-threatening arrhythmia or heart attack.
PVA most commonly occurs in people who smoke and people who have high cholesterol or high blood pressure. In many cases it occurs for unknown reasons in otherwise healthy people. In some cases it may be triggered by alcohol withdrawal, stress, exposure to cold, certain medications, or use of stimulants such as cocaine.
Treatment during an episode to relieve pain and shorten its duration involves sublingual nitroglycerin (a nitrate). Treatment to reduce the frequency of episodes and possibly reduce the risk of serious complications involves calcium channel blockers or long-acting nitrates. For people with PVA who smoke, quitting smoking can lead to a significant decrease in the frequency of episodes. While most people with PVA do not experience serious complications, it is a chronic condition that needs to be monitored over time.
Source: GARD Last updated on 05-01-20
The main symptom of Prinzmetal's variant angina is recurring episodes of chest pain (angina) that usually occur when a person is at rest, during bedtime hours (around midnight to 8am). Some people report feeling "discomfort" rather than "pain." In some people, pain may spread to the neck, jaw, shoulder, or arm. Other sensations during episodes may include tightness or pressure in the chest, "heart burn," nausea, sweating, dizziness, and palpitations. Episodes tend to last around 5 to 15 minutes (longer in some cases), and tend to be similar to each other.
Last updated on 05-01-20
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