Prinzmetal's variant angina is a vasospastic disorder that presents with rest angina and transient ST-segment elevation, and is highly responsive to calcium-channel blockers, conferring a generally excellent long-term prognosis.
Supports CCBs for variant angina with favorable survival; leaves open optimal strategies in refractory cases.
Although the prevalence of variant angina pectoris is unknown, it appears to be substantially less common than typical, exertional angina and unstable angina at rest. The patient with variant angina typically complains of a pressure-like, squeezing retrosternal chest discomfort of several minutes duration. The diagnosis is secured by the occurrence of transient ST-segment elevation in association with chest pain, both of which resolve spontaneously or with nitroglycerin. After the diagnosis is made, the patient usually becomes symptom-free on calcium-channel blockers with or without long-acting nitrates. Although the long-term survival of these patients is excellent, an occasional individual with variant angina sustains a complication, most often myocardial infarction, a life-threatening arrhythmia, or sudden cardiac death.
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Mayer et al. (1998) studied this question.
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