How To Prevent Prinzmetal Angina

Having a heart attack is probably one of the most frightening turns our health can take.

More often than not, the warning signs are there for us, and they can rise up in a way that convinces us we are actually having a heart attack.

However, angina is just the beginning.

There are several types, and Prinzmetal angina is one of the rarest.

That being said, in the rare event that you do get it, this is a big clue that you need to take better care of your heart health.

What is Prinzmetal Angina?


Prinzmetal angina is sometimes known as angina inversa, or variant angina. In layman’s terms, it is a coronary spasm, where the muscles in the heart’s wall suddenly contract.

prinzmetal angina chest pain

This reduces the blood flow to the heart, which causes a sharp pain in the chest, which many would mistake for a heart attack.

Also, unlike angina, which flairs up during physical exertion, Prinzmetal angina symptoms usually happen when you are at rest. In fact, quite often it will happen while you are sleeping, sometime in the middle of the night – not a fun way to wake up at all.

This type of angina is very rare, accounting for around 2% of all angina cases.

The reasons for this happening are still unclear, but it does seem to occur more often in younger women than any other demographic.

Some potential triggers for a spasm include:

  • Prolonged exposure to cold environments
  • Stress
  • Medicines that cause narrowing of the blood vessels
  • Smoking
  • Cocaine

Some Key Insights on Prinzmetal Angina


Suffering from chest pains is not only uncomfortable in the moment, but also a worrying thing to have on your mind, as it is one of the principal symptoms of coronary artery disease.

But if you are young, and have no history or known heart problems, then it may be a coronary spasm. As rare is this disorder is, it’s definitely a possibility.

Here are some important things to know about Prinzmetal angina.


How is This Different from Coronary Artery Disease?


prinzmetal angina diagram

If you have severe coronary artery disease, the pain and pressure in your chest is because of a blockage in the arteries, which is reducing the amount of blood and oxygen going to the heart. Physical exertion will acerbate the problem.

On the other hand, Prinzmetal angina almost always happens when you are asleep. It can also happen during physical activity, and the pain is so severe that you may actually lose consciousness.

Typically, an episode will last about five or ten minutes. It might happen every day, or just a few times each year.

In most cases, someone who suffers from coronary spasm will have a mild case of coronary artery disease too. While the reasons for the spasm are unclear, the following may be factors:

  • Inflamed chest cartilage
  • Muscle spasm
  • Some issue with the stomach or esophagus

How is Prinzmetal Angina diagnosed?


In order for medical staff to be able to diagnose a patient with Prinzmetal angina, they may request that the person wear a Holter monitor for a period of 24-48 hours.

prinzmetal angina

This specialized monitor will record the electrical impulses in your heart, even as you sleep. Should you get a coronary spasm during this time, the doctors can view the changes in your heart’s activity. This is done through an electrocardiogram (EKG).

However, it can be a little tricky to diagnose, as not every patient will demonstrate EKG changes with every episode of Prinzmetal angina.

For a solid diagnosis, medical staff usually conduct a stress test with the intravenous drug, ergonovine. This is injected into the patient, typically in the arm or leg, and it will trigger a coronary spasm within minutes.

Don’t worry though, the doctors will have everything under control, and they inject a counter-medication to stop the spasm.

Throughout this process, before the injection, during the spasm, and after the counter-medication is injected, the doctors record the EKG of your heart.


Will a Coronary Spasm Trigger a Heart Attack?


blood vessel

This is the biggest concern of anyone who has Prinzmetal angina.

It is possible for a spasm to cause a heart attack, but if you take calcium blockers, then it’s unlikely to happen.

These spasms cause an abnormal heart rate, so it’s important to get to a hospital if you feel any of the following:

  • The chest pains don’t subside after two doses of nitroglycerine
  • You experience other known heart attack symptoms
  • You feel as if you may pass out

Treatment of Prinzmetal Angina


old man having a therapy

Your doctor can prescribe medicine if you have Prinzmetal angina, which will help to control the spasms and also offer pain relief.

The mainstays used to treat this form of angina include nitrates and calcium antagonists. By taking these, you can fend off the chances of a heart attack, and reduce spasms to a minimum.

Nitroglycerine is great for relieving the chest pains related to angina, and if it is a long-acting form of the drug, it may help to prevent future attacks.

Calcium blockers are taken in large doses, and many people require several types. Side-effects of taking the calcium blockers include swelling in the legs and a low pulse rate.

Quite often, the spasms will arise in cycles, appearing for a little while, before disappearing again. When you’ve been on medication for a period of six months or more, the doctors will start reducing your dosage gradually.

Although the prognosis for Prinzmetal angina is good, it is still something that you should update your healthcare provider about.


Home Treatment for Prinzmetal Angina


If you have even one coronary spasm, then waste no time in getting to the doctor. This is a serious condition, and not one you should shrug off or downplay at all.

While the doctors and medical team at a good hospital can do most of the important work in diagnosing and treating your angina, you can make some lifestyle changes to manage the symptoms too.

It’s a good idea to do all of these:

Quit Smoking

no smoking sign

Smoking tobacco causes your blood vessels to constrict, which leads to a reduced blood flow. Furthermore, smoking will promote a build-up of hard plaque in your arteries, which causes further complications for Prinzmetal angina.

Manage Stress Levels

women stress

With stress comes the hormone cortisol. Too much of this can worsen the symptoms of angina, which are made worse with the combination of high blood pressure and constricted blood vessels.

Avoid Hyperventilating

women is vomitting

Take care not to overexert yourself, as breathing hard for an extended time can trigger for symptoms.

Eat a heart-healthy diet

heart shape vegetables

Eat plenty of fruit and vegetables, especially dark, leafy greens. It’s a smart move to avoid too many refined carbohydrates, and also swap out red meat for fish.

Avoid severely cold weather

snow plowing

Cold climates and environments can pose challenges for your cardiovascular system. Anyone with angina or heart troubles should stay in warmer areas.

Get to know your rhythm

moon diagram

Prinzmetal angina has a circadian rhythm, which tends to follow a pattern of attacks. By getting familiar with your “danger times”, you can prepare appropriately by taking it easy around these times and having the necessary medicine or assistance available if needs be.

Try yoga or a form of relaxation therapy

women acrobating

The health benefits of yoga and similar activities are well-founded, as it is known to be a great way to combat stress.

The Outlook is Not So Bleak with Prinzmetal Angina


Prinzmetal angina is a chronic condition, and anything that causes spasms in the coronary artery should be taken seriously. You can expect that it will stay with you for life, with multiple reoccurrences.

That being said, with good medical care, it is possible to enjoy a happy and normal life. However, you have a big part to play in that.

It is crucial that you follow the advice of your doctor, and make the necessary changes to your lifestyle. In doing so, you won’t just avoid triggering the angina more, but you could add years to your life.

Sticking to a low-fat diet with plenty of fresh fruit is key, as is regular exercise and avoiding smoking or extreme physical exertion.

Your doctor can give you more advice on a diet and exercise regime befitting your specific situation and physical condition.

Try to reduce stress and manage your symptoms and you will soon find that Prinzmetal angina is something you control, not the other way around.

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