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Coronary Artery Disease
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Variant angina is also known as Prinzmetal angina or angina inversa. The condition is secondary to epicardial coronary artery spasm, signified by angina symptoms occurring at rest, but rarely after exertion. Many patients also have a significant obstruction of one or more major coronary arteries. If there is only mild obstruction or no fixed obstruction, the long-term outcome is better than when there are significant fixed obstructions. Having diabetes mellitus and variant angina affects the use of certain medications such as bisoprolol, if there are large fluctuations in blood glucose levels. This is because the drug can mask symptoms of hypoglycemia.
Clinical syndromes in acute coronary syndrome
Published in K Sarat Chandra, AJ Swamy, Acute Coronary Syndromes, 2020
Walk-through angina is usually defined as occurrence of angina during initial stages of effort with disappearance of discomfort with continued effort. This is found in two subsets of patients: those with variant angina where the initial coronary spasm causing angina is relieved on continued exercise, and patients with severe CAD where the relief of angina is due to delayed vasodilatation of collaterals.
The Cardiovascular System and its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Variant angina (Prinzmetal angina) is characterized by pain at rest and S-T segment elevation during an attack rather than depression; thus, it "varies" from typical angina pectoris. In some patients, variant angina seems to be related to occlusion of a single large vessel and vasospasm, although the condition is not always vasospastic or limited to involvement of a single vessel.
Pellets of phospholipids and d -glucose with improved intestinal absorption and oral bioavailability of salvianolic acid B
Published in Pharmaceutical Development and Technology, 2022
Ziyi Li, Zhenghua Li, Jianhua He, Jianping Liu
Danshen, the dried roots and rhizomes of Salvia miltiorrhiza, has been widely used in China for the therapy of cardiovascular and cerebrovascular diseases (Du et al. 2020). As one of the main hydrophilic active components in Danshen (Zhou et al. 2009), salvianolic acid B (SAB) provides various biological activities such as removal of oxygen free radicals, inhibition of platelet aggregation, etc. (Xue et al. 2014). Specifically, SAB can increase the release of endothelial NO (Lam et al. 2006) and alleviate coronary artery spasm (Lin et al. 2016) to treat variant angina (VA) pectoris. VA arises from coronary artery spasm related to myocardial ischemia, which may lead to acute outcomes, such as myocardial infarction (MI) and out-of-hospital cardiac arrest (Xu and Yang 2015). It was reported that the 3-year MI mortality was 3% in Japanese, 2% in Korean, and 11% in western countries (Pikkarainen et al. 2019), suggesting prevention and treatment of VA is crucially important. However, SAB is poorly absorbed due to the low effective permeation coefficient (Peff), undergoes rapid first-pass effect and tends to be degraded in intestine (Liu et al. 2016), characterized by its poor absolute bioavailability as low as 1.07% in beagle dogs (Gao et al. 2009) and 2.3% in rats (Wu et al. 2006), which hindered its clinical use.
Angina due to coronary artery spasm (variant angina): diagnosis and intervention strategies
Published in Expert Review of Cardiovascular Therapy, 2021
Thanh Ha Nguyen, Gao-Jing Ong, Olivia C Girolamo, Viviane De Menezes Caceres’, Armin Muminovic, Yuliy Y Chirkov, John D Horowitz
Over the next 15 years, there were only occasional reports of ‘Prinzmetal’s variant angina’, but with the advent of diagnostic coronary angiography, it became increasingly obvious that some patients had no fixed obstructive coronary artery disease, but that in many cases, spontaneous spasm of one or more coronary arteries were observed during pain. A report by Oliva et al. [3] was typical of this development: spasm was observed, and it was noted that, although the clinical syndrome described by Prinzmetal [1] was quite common, only 14 cases of CAS had been documented previously. Thus, at this early stage, it was obvious that the definitive diagnosis of CAS involving the large coronary vessels was always going to present some difficulties, unless some diagnostic modality beyond routine coronary angiography became available. Indeed, the period between 1975 and 1978 saw a substantial increase in the utilization of intravenous ergonovine, an ergot alkaloid predominantly used in obstetrics, as a diagnostic test for CAS, via provocation of spasm [4].
Coronary vasospasm as an etiology of recurrent ventricular fibrillation in the absence of coronary artery disease: a case report
Published in Journal of Community Hospital Internal Medicine Perspectives, 2021
Binita Bhandari, Tejaswi Kanderi, Keerthi Yarlagadda, Mehreen Qureshi, Saketram Komanduri
Vasospastic angina (VA), also known as Prinzmetal’s angina, or variant angina, is a clinical entity first described by Prinzmetal et al. in 1959 as ‘angina at rest due to coronary artery vasospasm with transient ischemic electrocardiogram changes that resolve with short–acting nitrates’ [1]. It results from coronary vasospasm and can occur with or without coronary artery disease. It usually presents as chest pain at rest or at night that lasts longer than the typical chest pain in acute coronary syndrome (ACS). It can sometimes be associated with ACS, arrhythmias, and sudden cardiac death, or the clinical presentation can be variable leading to under diagnosis of the condition [2].