In this post we will discuss: Introduction of prinzmetal angina i.e angiospastic angina , symptoms of prinzmetal's angina, The Drug of choice in prinzmetal angina and contraindication Of Beta blockers in prinzmetal angina.
Introduction To Prinzmetals's angina:
Angiospastic angina or Prinzmetal angina is characterized by spasticity in coronary vessels i.e arteries.this syndrome is also known by other names like angiospastic ischemia, coronary vessel spasm, angina inversa, varient angina and vasospastic angina.the condition is characterized by recurrent cardiac chest pain even in rest.the particular reason is the stiffness of coronary arteries, unlike angina pectoris or myocardial infarction where the primary reason is the build up of fats and cholesterol in coronary vessels (atherosclerosis).the spasticity or in simple words stiffness occur because of the contraction of smooth muscles in the vessels.Signs And Symptoms Of Prinzmetal Angina:
Although angiospastic angina share most of the symptoms and signs with other ischemic heart diseases yet there are some elements of differential diagnoses.
- unlike atherosclerosis where people of old age and with major coronary risk factors like obesity, weight gain etc are mostly effected, in prinzmetal angina young age patients are also at stake being the major risk factor as smoking.
- The cardiac examination in often normal unless ischemia develops.
- The symptoms appear usually at rest in angiospastic angina while often a strenuous exercise or physical exertion with others.
ECG Identification:
The ecg of a patient with prinzmetal angina angina is with an ST elevation Pattern, which is also confused with acute STEMI (st elevation myocardial infarction).However unlike STEMI the ecg changes in angiospastic ischemia are more reversible and temporary.
Drug Of Choice And Contraindication:
Beta blockers are highly contraindicated in angiospastic angina as their use can worsen the condition.
The reason behind the contraindication of beta blocker in prinzmetal angina is that when beta blocker if administered it will indirectly promote agonistic action of cathecolamines on alpha 1 receptors in blood vessels leading to vasoconstriction, because cathecolamines are agonists for both alpha and beta receptors so when beta receptors are blocked cathecolamines may find its way through alpha receptors.
however other drugs are safe.
The reason behind the contraindication of beta blocker in prinzmetal angina is that when beta blocker if administered it will indirectly promote agonistic action of cathecolamines on alpha 1 receptors in blood vessels leading to vasoconstriction, because cathecolamines are agonists for both alpha and beta receptors so when beta receptors are blocked cathecolamines may find its way through alpha receptors.
however other drugs are safe.
the particular drug of choice are calcium channel blockers like verapamil, diltiazem, nifidipine etc in prinzmetal angina.
