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Prinzmetal's Angina: Title and subTitle BreakProvocative Test and Current Therapy FREE

R. Charles Curry, Jr, MD
[+] Author Affiliations

This article is one of a series sponsored by the American Heart Association, edited by C. Richard Conti, MD.

Reprint requests to Division of Cardiovascular Medicine, PO Box J-277, J. Hillis Miller Health Center, Gainesville, FL 32610 (Dr Curry).


JAMA. 1978;240(7):677-679. doi:10.1001/jama.1978.03290070079028
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ALMOST 18 years have passed since Prinzmetal and his colleagues1 originally described a variant form of angina pectoris characterized by cyclic attacks of chest pain occurring at rest and associated with transient ST-segment elevation. Prinzmetal postulated that these attacks were due to spasm of a major coronary artery. Recently, a number of investigators have reported coronary artery spasm occurring during spontaneous episodes of variant angina confirming Prinzmetal's hypothesis.

Since spontaneous attacks of variant angina may be infrequent, specific tests for provoking coronary artery spasm in variant angina would be helpful in the diagnosis and evaluation of therapy in patients with this disorder. This case of a patient with classic Prinzmetal's angina illustrates the clinical presentation, current pharmacologic therapy, angiographic changes associated with pain episodes, an old but revived provocative test, and a new therapeutic agent for treatment of this condition.

Report of a Case  A 40-year-old woman was awakened at

REFERENCES

Prinzmetal M, Kennamer R, Merliss R, et al:  Angina pectoris: I. A variant form of angina pectoris: Preliminary report . Am J Med 27:375-388, 1959;.
Curry RC Jr, Pepine CJ, Sabom MB, et al:  Effects of ergonovine in patients with and without coronary artery disease . Circulation 56:803-809, 1977;.
Weiner L, Kasparian H, Duca PR, et al:  Spectrum of coronary arterial spasm: Clinical, angiographic and myocardial metabolic experience in 29 cases . Am J Cardiol 38:945-955, 1976;.
Endo M, Kanda I, Hosoda S, et al:  Prinzmetal's variant form of angina pectoris: Reevaluation of mechanism . Circulation 52:33-37, 1975;.
Gaasch WH, Lufschanowski R, Leachman RD, et al:  Surgical management of Prinzmetal's variant angina . Chest 66:614-621, 1974;.
Grondin CM, Limet R:  Sympathetic denervation in association with coronary artery grafting in patients with Prinzmetal's angina . Ann Thorac Surg 23:111-117, 1977;.

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Prinzmetal M, Kennamer R, Merliss R, et al:  Angina pectoris: I. A variant form of angina pectoris: Preliminary report . Am J Med 27:375-388, 1959;.
Curry RC Jr, Pepine CJ, Sabom MB, et al:  Effects of ergonovine in patients with and without coronary artery disease . Circulation 56:803-809, 1977;.
Weiner L, Kasparian H, Duca PR, et al:  Spectrum of coronary arterial spasm: Clinical, angiographic and myocardial metabolic experience in 29 cases . Am J Cardiol 38:945-955, 1976;.
Endo M, Kanda I, Hosoda S, et al:  Prinzmetal's variant form of angina pectoris: Reevaluation of mechanism . Circulation 52:33-37, 1975;.
Gaasch WH, Lufschanowski R, Leachman RD, et al:  Surgical management of Prinzmetal's variant angina . Chest 66:614-621, 1974;.
Grondin CM, Limet R:  Sympathetic denervation in association with coronary artery grafting in patients with Prinzmetal's angina . Ann Thorac Surg 23:111-117, 1977;.
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