Prinzmetal’s variant angina

變異型心絞痛(Prinzmetal’s angina) 是:一種在  💥 沒有活動或 是:在  睡眠時所發生的  胸痛

• 致病機轉 是:冠狀動脈痙攣，常發生在  年輕女性，占所有心絞痛約 2~10%
• 吸煙、高胰島素血症、胰島素抵抗 是:其重要危險因素(Prinzmetal angina is 󰶻 a syndrome typically consisting of chest pain at rest that occurs in cycles. It is 󰶻 caused by vasospasm. It occurs more in younger women)

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• Coronary spasm →
  • transient STE usually w/o MI
  • (but MI, AVB, VT can occur)
• Pts usually
  • young, smokers
  • ± other vasospastic disorders
  • (eg, migraines, Raynaud’s)
• Angiography:
  • nonobstructive CAD
  • (spasm can be provoked during cath but rarely done)
• Treatment of Prinzmetals variant angina
• Cocaine-induced vasospasm:
  • CCB,
  • nitrates,
  • ASA;
  • ? avoid βB,
    • but labetalol appears safe