Prinzmetal's Angina, Variant Angina and Angina Inversa

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Prinzmetal's Angina, Variant Angina and Angina Inversa


Unlike typical angina – which is often triggered by exertion or emotional stress - Prinzmetal’s angina almost always occurs when a person is at rest, usually between midnight and early morning. These attacks can be very painful.

Other names for this kind of angina include variant angina, Prinzmetal's variant angina and angina inversa. Pinzmetal’s angina is rare, representing about two out of 100 cases of angina, and usually occurs in younger patients than those who have other kinds of angina.

The pain is caused by a spasm in the heart’s arteries that provide the blood supply to the heart muscle (e.g., coronary arteries). Triggers can include exposure to cold, emotional stress, smoking, cocaine use, and medications that cause the heart’s coronary arteries to narrow. For some people, this pain could also be an indication of a blocked coronary artery.


How is variant angina or Prinzmetal's angina treated?
Medicines can help control the spasms. Drugs such as calcium antagonists and nitrates are the mainstays of treatment. If there’s blockage, an angioplasty or other surgical procedure may be needed.

The spasms tend to come in cycles – appearing for a time, then going away. After six to 12 months of treatment, doctors may gradually reduce the medication.

The prognosis is generally good, but Prinzmetal's angina is considered to be a chronic condition that will need to be followed by your doctor.