Prinzmetal angina: a literature review

Karina Brizickaja1, Ieva Daniliauskaitė1

1 Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania


Prinzmetal angina (PA) is a rare cardiological disease characterized by episodic chest pain due to coronary artery spasm. Cardiovascular spasms can be caused by various pathophysiological mechanisms that disturb the balance of vasoconstrictive and vasodilatory substances. PA can be provoked by various triggers: smoking, alcohol, certain medicaments, stress or hyperventilation. PA diagnostic criteria include nitrate-responsive angina, ischemic electrocardiogram changes and coronary artery spasm detected during cardiac catheterization by drug-induced provocative tests. Acute coronary artery spasm attacks can be relieved by the administration of nitroglycerin. Long-acting nitrates and calcium channel blockers are used to prevent vasospastic episodes. It is also recommended to make healthy lifestyle changes and avoid predisposing factors for coronary spasms to ensure long-term remission of angina. Undiagnosed and untreated PA may lead to life-threatening complications such as myocardial infarction, arrhythmia or sudden cardiac death. Therefore, it is important to understand the potential threat of untreated PA and to promote early identification and diagnosis of this disease. This review reveals the main etiological factors of Prinzmetal angina, its symptoms, diagnostic criteria and treatment peculiarities.

Keywords: Prinzmetal angina, variant angina, chest pain, coronary artery spasm.