Prinzmetal angina chest pain not only usually occurs at rest, but it can be severe.
The severity of chest pain from Prinzmetal angina can be enough to awaken one from sleep.
Though it usually occurs while one is asleep overnight, it may occur during activity and can even make a person pass out.
It is caused by a spasm in a coronary artery that may or may not have plaque buildup.
Soft or hard plaque or fatty deposits in a coronary artery have nothing to do with Prinzmetal angina.
However, the rare condition may also occur in those with coronary blockages.
Frequency of spasms may be just a few times a year or a few times a day and last under 15 minutes.
Prinzmetal angina can cause a heart attack, but this is unlikely if the patient is taking calcium blocker drugs as a treatment.
Another drug that’s used for this condition is nitroglycerin.
Diagnosis
Chest pain overnight has many causes including muscle strain and acid reflux.
For the diagnosis of Prinzmetal angina, one must wear a Holter monitor for up to 48 hours to record the heart’s electrical impulses.
However, not all incidents of coronary artery spasm will register on the EKG strip that’s produced by the Holter monitor.
Another way to diagnose is via the ergonovine stress test.
Ergonovine is a drug that’s administered intravenously and may trigger a spasm, typically within minutes.
At that point the patient is injected with another drug to stop the spasm. All this time an EKG is running.
