Spontaneous Angina: Understanding Variant Angina and Its Symptoms

Spontaneous angina, commonly referred to as variant angina or Prinzmetal's angina, is a unique type of chest pain that differs significantly from the more common forms of angina. Unlike typical angina, which is often triggered by physical exertion or emotional stress, variant angina occurs at rest and is primarily caused by coronary artery spasms.

What Triggers Variant Angina?

This form of angina often occurs during the early hours of the morning, typically between 2 and 3 a.m., when the body is in a state of deep rest. Patients may suddenly awaken due to a feeling of tightness or pressure in the chest. These spasms can restrict blood flow to the heart muscle, causing discomfort and potentially leading to more serious cardiac events if left untreated.

Key Characteristics of Variant Angina

Duration and Frequency

Unlike exertional angina, which is usually short-lived and subsides with rest, variant angina attacks tend to last longer—often around 15 minutes. The episodes may recur at the same time each day, particularly during the night or early morning hours, making it a predictable yet concerning condition.

Underlying Cause

The primary cause of variant angina is coronary artery spasm. This constriction of the blood vessels supplying the heart can occur in both healthy and diseased arteries. It is not related to physical activity, which makes it distinct from other types of angina.

Treatment and Management

Since variant angina is caused by spasms in the coronary arteries, treatment typically focuses on preventing these episodes through medication. Calcium channel blockers and nitrates are commonly prescribed to relax blood vessels and reduce the frequency and severity of attacks. Patients are also advised to avoid known triggers such as stress, cold weather, and stimulants like nicotine and caffeine.

Understanding variant angina is crucial for effective management and prevention of complications. If you experience recurring chest pain at rest, especially during the night, it is important to seek medical evaluation to determine the underlying cause and begin appropriate treatment.