Angina rest/variant/Prinzmetal

The principal forms relevant to choice of drug therapy are angina of exercise (commonest) and its worsening form, unstable (preinfarction or crescendo) angina (see below), which occurs at rest. Variant (Prinzmetal) angina (very uncommon) results from spasm of a large coronary artery. 

Variant (Prinzmetal s) Angina Hypoxia and ischemia to myocardium is caused by vasospasm (rather than progressive narrowing of coronary arteries). Episodes may occur at rest, often at the same time each day. S-T elevation on ECG. 

Variant (Prinzmetal, vasospastic). Variant angina occurs at rest and is due to a vessel spasm (vasospasm). 

Patients with variant or Prinzmetal angina secondary to coronary spasm are more likely to experience pain at rest and in the early morning hours. Pain is not usually brought on by exertion or emotional stress nor is it relieved by rest the electrocardiogram (ECG) pattern is that of current injury with ST-segment elevation rather than depression. 

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