Last updated on March 4th, 2025 at 10:10 am
What is Vasospastic Angina Pectoris?
Vasospastic angina pectoris is also known as Prinzmetal’s angina or variant angina. It is a rare but serious medical form of chest pain caused by sudden spasms of your coronary arteries. Unlike stable angina, which is triggered by physical exertion, vasospastic angina occurs at rest, often during the early morning hours. The condition can reduce blood flow to your heart, leading to temporary chest pain and, in severe cases, heart attacks.
Vasospastic Angina Causes
Vasospastic angina is primarily caused by a temporary constriction (spasm) of your coronary arteries especially the left main artery, reducing blood supply to your heart. Key factors that can trigger these spasms include:
- Smoking – One of the most significant risk factors.
- Exposure to cold– Sudden cold temperatures can constrict arteries.
- High-stress levels – Emotional stress and anxiety increase the risk.
- Drug and Substance Use – Cocaine, amphetamines, and alcohol can provoke spasms.
- Hyperventilation – Rapid breathing may contribute to an attack.
- Inflammation – Conditions like lupus and rheumatoid arthritis may increase the risk of susceptibility.
- Genetic factors – A family history of coronary artery spasm could increase the risk.
Vasospastic Angina Symptoms
Understanding the symptoms of vasospastic angina pectoris can help you differentiate it from other forms of chest pain. Common signs include:
- Chest pain (angina pectoris) – A squeezing, burning, or tight sensation, usually behind the breastbone.
- Pain at rest – Often occurs early in the morning or at night.
- Pain relief with nitroglycerin – Symptoms typically improve after taking nitroglycerin.
- Episodes lasting a few minutes – Unlike heart attacks, the pain subsides relatively quickly.
- Possible radiating pain – Discomfort may spread to the shoulders(check shoulder pain when crossing your arms), neck, or arms.
- Dizziness or fainting – Severe cases may lead to temporary loss of consciousness.
- Irregular heartbeat (arrhythmia) – A feeling of skipped or rapid heartbeats.
How is Vasospastic Angina Different from Other Types of Angina?
| Feature | Vasospastic Angina | Stable Angina | Unstable Angina |
|---|---|---|---|
| Trigger | Rest or night | Physical exertion | Unpredictable |
| Duration | Minutes | Few minutes | Can be prolonged |
| Relief | Nitroglycerin | Rest & medication | Medical emergency |
| Risk | Can lead to heart attack | Less risky | High heart attack risk |
Vasospastic Angina Diagnosis
If you suspect you have vasospastic angina pectoris, a doctor may perform the following tests:
- Electrocardiogram (ECG) – To check for abnormal heart rhythms during an episode.
- Holter monitor – A portable ECG worn for 24-48 hours to detect spasms.
- Coronary angiography – Uses contrast dye to visualize artery function.
- Ergonovine test – A provocative test that induces spasms under controlled conditions.
- Blood tests – To check for underlying inflammation or risk factors.
Vasospastic Angina Treatment
1. Medications
The primary treatment for vasospastic angina pectoris involves medications that help relax the coronary arteries and prevent spasms.
- Calcium Channel Blockers (CCBs) – First-line treatment to relax artery walls and prevent spasms (e.g., Amlodipine, Diltiazem, Verapamil).
- Nitrates – Short-acting (Nitroglycerin) and long-acting nitrates help dilate blood vessels and relieve symptoms.
- Statins – Reduce inflammation and improve artery health.
- Beta-Blockers (Caution!) – Not usually recommended because they may worsen spasms.
2. Lifestyle Changes
- Quit smoking – Smoking is a major trigger for spasms.
- Manage stress – Meditation, deep breathing, and therapy can reduce attacks.
- Avoid cold exposure – Dressing warmly in cold environments minimizes risk.
- Limit alcohol and caffeine – These substances may trigger episodes.
- Regular exercise – Mild to moderate exercise improves overall heart health.
3. Emergency Treatment During an Attack
- Take sublingual nitroglycerin immediately.
- Sit down and breathe slowly to avoid hyperventilation.
- Avoid sudden exertion or stress (Which can cause Exertional Angina).
- If pain persists beyond 10 minutes, seek emergency medical help.
Can Vasospastic Angina Be Cured?
There is no permanent cure for vasospastic angina pectoris, but it can be effectively managed with the right treatment plan. Many patients live normal lives by following their doctor’s advice and avoiding triggers.
What you Might Be Asking
1. Is vasospastic angina life-threatening?
If left untreated, Vasospastic angina can increase the risk of heart attacks and arrhythmias.
2. Can you exercise with vasospastic angina?
You can exercise with vasospastic angina pectoris but you should consult your doctor before engaging in physical activity.
3. How long do vasospastic angina attacks last?
Episodes usually last 5 to 15 minutes and resolve with nitroglycerin.
4. Does vasospastic angina show up on an ECG?
Only if an episode occurs during the test. A Holter monitor may be more effective in detecting spasms.
5. Can stress trigger vasospastic angina?
High-stress levels can induce artery spasms, making stress management essential.
Vasospastic angina pectoris is a serious but manageable condition. You need to know the symptoms, triggers, and treatment options that can help you prevent complications and improve your quality of life. If you suspect you have this condition, consult your doctor immediately for diagnosis and personalized treatment. Do you know the angina variant called Microvascular Angina?… discover how different it is from the vasospastic Angina in the link
By taking proactive steps such as avoiding triggers, managing stress, and using medications, you can effectively control vasospastic angina and lead a healthier life.