Key result
Two-hourly coronary vasodilators prevent anginal episodes in a patient with Prinzmetal variant angina and syncope.
Case Report (n=1)
Coronary arterial vasodilator therapy successfully prevented anginal episodes in a patient with Prinzmetal variant angina and syncope not responsive to demand cardiac pacing.
May warrant vasodilator trial when pacing fails in Prinzmetal angina; single case leaves open generalizability and safety.
A case of Prinzmetal variant angina with transient complete atrioventricular block and syncopal episodes following an anteroseptal myocardial infarction is described. The syncopal attacks were not prevented by demand cardiac pacing and were presumably caused by transient severe ischaemia of the left ventricle, with a consequent reduction in cardiac output. The left ventriculogram showed a large anterior dyskinetic area corresponding to the high grade proximal obstruction in the left anterior descending artery demonstrated by coronary angiography. All other coronary vessels appeared free of disease and it is suggested that the anginal episodes were caused by transient proximal segmental spasm of the right coronary artery. The anginal episodes were successfully prevented by a regimen of two-hourly coronary arterial vasodilator therapy.
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Harper et al. (1975) conducted a case report in Prinzmetal variant angina (n=1). Coronary arterial vasodilator therapy was evaluated on Anginal episodes. Two-hourly coronary arterial vasodilator therapy successfully prevented anginal episodes in a patient with Prinzmetal variant angina and syncope.
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