Prinzmetal's Angina

Prinzmetal's angina is a rare type of variant angina that is seen in people. Attacks of Prinzmetal's angina often occur at night, or when the person is not doing any kind of strenuous activity, or is at rest, as against other types of angina, where the person normally gets an attack when he or she is doing some very physically exerting work. Furthermore, in Prinzmetal's angina, the pathogenesis of the attack is also different when compared to other types of angina. Given below is a detailed explanation of the causes, symptoms, diagnosis and treatment options for this problem.

Causes
The cause for Prinzmetal's angina is the involuntary vasospasm of the coronary artery. Coronary arteries are the arteries that supply blood to the chambers of the heart. Thus, they are vital for normal functioning of the human heart, as they are the only source of oxygen and nutrition of the heart muscles. In Prinzmetal's angina, there are cyclic attacks of spasms of the coronary artery, which leads to insufficient oxygen and blood supply to the heart muscles, thus causing severe pain and discomfort in the chest region. What exactly causes or triggers such coronary spasm attacks is not known, although it is said that smoking and atherosclerosis maybe trigger factors. Repeated attacks of this kind can also lead to severe ischemia of the heart muscles, causing ischemic cardiomyopathy and other related heart diseases.

Symptoms
One of the main Prinzmetal's angina symptoms is severe and crushing chest pain. This chest pain is quite characteristic in nature, as it normally occurs at night, when the person is sleeping or is in supine position. A patient will often describe such pain as a feeling of tightness in chest with a crushing sensation. The pain is felt just under the chest bone and it may radiate to the neck, arms and shoulders. The duration of pain will vary from person to person - for some people, the attack may last for only a few seconds, while for some it may last for a few minutes. In certain severe cases, if the pain is very severe, it may lead to fainting and loss of consciousness. Sometimes, this sharp pain in chest maybe accompanied by other symptoms, like shortness of breath, body pain, nausea etc. In some cases, if the spasms increase in frequency and severity, it can even lead to a heart attack.

Diagnosis
Although the symptoms are very characteristic and are quite a giveaway, it is important to take many things into consideration before reaching a final diagnosis of Prinzmetal's angina. The pattern of attacks should be studied to ensure that they only occur at night or when the person is resting, so as to rule out angina pectoris and other types of angina. Along with the signs and symptoms, there are other investigations that are also done, like, a full blood count, platelet count, cardiac enzymes, ECG, etc. All of these combined will help reach a final diagnosis of Prinzmetal's angina.

Treatment
There is no fixed and final treatment for Prinzmetal's angina. Thus, the treatment offered will entail preventing the frequency, duration and severity of attacks. Normally, as an immediate measure for a person who is getting an attack of Prinzmetal's angina, sublingual nitroglycerine is given, which helps in providing almost instant relief. Sometimes, repeated and severe attacks of this angina may even require hospitalization. The more important aspect of dealing with this condition, is prevention. Inculcation of healthy habits, like regular exercising, cessation of smoking, lowering cholesterol and eating fresh healthy fruits, etc., will greatly help in preventing any further attacks.

Although this disease is a relatively rare form of angina, it is important that a person gets it diagnosed and treated at the earliest, so as to prevent any further complications which might prove to be fatal.