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What is variant angina? How does it differ from stable angina?
The impact of cardiovascular disease on today's society cannot be ignored, especially angina pectoris, whose different types of symptoms are difficult to identify. Variant angina, also known as Prinzmetal's angina, is very different from stable angina in that the former often occurs at rest or during sleep, while the latter often occurs during exercise or exertion.
Variant angina is caused by spasm of the coronary arteries, which is completely different from stable angina due to persistent infarction caused by arteriosclerosis.
Symptoms and diagnosis of variant angina
People with variant angina are usually young and have few risk factors, except smoking. Such patients experience symptoms such as chest pain, throat tightness, chest pressure, dizziness, excessive sweating and decreased exercise tolerance. These symptoms occur mainly at night or early in the morning and are usually unrelated to physical activity.
Unlike stable angina, the symptoms of variant angina do not necessarily lead to myocardial infarction and progress relatively slowly.
The cardiac examination may be normal in most cases, but when the coronary arteries show no evidence of other heart disease, the cardiologist may suspect variant angina based on this feature. Typical first aid measures include an electrocardiogram (ECG) to rule out other problems.
Mechanisms of variant angina
Although the specific mechanism is not fully understood, several hypotheses have been proposed. These include robust contraction of vascular smooth muscle, and reduced nitric oxide availability may lead to endothelial dysfunction. Additionally, stress, cold, and the use of certain medications are thought to be triggers for attacks.
Medical research shows that certain stimulants, such as nicotine and cocaine, can significantly increase the chance of variant angina attacks.
Diagnosis and prevention
Variant angina usually requires cardiac catheterization and the use of stimulators to confirm the constriction of the coronary arteries. In terms of prevention, smoking, emotional stress and exposure to extreme cold are major factors that should be avoided. Following a healthy lifestyle and reducing triggers will help control the frequency of attacks.
Treatment of variant angina
In the case of an acute attack, rapid-acting sublingual or intravenous nitroglycerin will provide rapid relief. As long-term maintenance therapy, calcium channel blockers are considered the drugs of choice. Additionally, patients should avoid prolonged use while on nitroglycerin as this may lead to drug tolerance.
For patients whose symptoms are not well controlled, consideration may be given to adding another class of calcium channel blockers or long-acting nitroglycerin.
Looking to the future
Many people with variant angina have a good prognosis with appropriate treatment. According to statistics, the survival rate of approximately 90% of patients within five years is estimated to be over 90%. However, ongoing monitoring and evaluation of patients is still necessary to ensure that heart health is maintained.
As we gain a better understanding of variant angina, we may be able to develop more targeted treatment options. Have you ever thought about how to better protect your heart health in our busy modern life?
