What are the characteristics of variant angina?

The occurrence of variant angina pectoris actually poses a great hidden danger to the patient's health. If it is not treated in time, it may threaten the patient's life. Patients with variant angina often have obvious symptoms, such as severe and prolonged duration of symptoms, increased or decreased blood pressure, irregular heartbeat, etc., which can all be detected in time.

Variant angina (variant angina pectoris; Prinzmetal's angina) is angina pectoris secondary to large vessel spasm. It is characterized by the onset of angina pectoris at rest, unrelated to fatigue and mental stress, and can be relieved by bed rest. It is a special type of angina pectoris accompanied by ST segment elevation, which can lead to acute myocardial infarction, severe arrhythmias (including ventricular tachycardia and ventricular fibrillation) and sudden death.

Symptoms and signs

1. Pain often occurs during rest and daily activities.

2. It is more severe and lasts longer than ordinary angina pectoris.

3. The duration varies from tens of seconds to 30 minutes; some present as a series of short attacks, each lasting 1 to 2 minutes, and reappearing after an interval of several minutes.

4. It is cyclical and often occurs at a certain time every day, especially in the middle of the night or early morning.

5. It is not related to fatigue or mental stress, has no obvious cause, and is not relieved by bed rest.

6. The patient's blood pressure rises during an attack, and in a few cases, the blood pressure drops.

7. Nitroglycerin or nifedipine can provide rapid relief.

8. It may be accompanied by arrhythmias, such as premature ventricular contractions, tachycardia or conduction block.

In addition to the above signs, experts will introduce you to the four major characteristics in detail:

1. The pain of angina pectoris is most commonly found in the middle or upper 1/3 of the sternum. In the most typical cases, the pain often starts from the sternum and can radiate to the left shoulder, the anterior and medial side of the left upper limb, and the ring finger and little finger. Sometimes the pain radiates and has a "jumping" phenomenon, such as complaining of pain in the left shoulder and left hand, while other parts of the arm are not affected. In a small number of patients, pain first occurs in peripheral areas, such as the jaw or wrist, and only spreads to the sternum area after the condition worsens.

2. The pain symptoms of angina pectoris are discomfort or pain in the precordial area, which is generally mild to moderate and can be relieved by slowing down the pace or stopping activity. There are also many people who insist on denying chest pain, only describing it as "squeezing", "heavy" or "tightness", or may complain of "band-like" or "clamp-like", but will not say it is "knife-like" or "knife-like" pain. It is often accompanied by a feeling of suffocation and discomfort in the arms, generally described as heaviness, weakness or dull pain. If it radiates to the fingers, it is often reported as numbness or tingling; if it radiates to the neck, there is often a feeling of choking; if it radiates to the jaw, there may be a dull pain, sometimes similar to toothache.

3. The most common trigger of angina pectoris is physical activity, and the amount of exercise required to induce pain varies greatly. In the most serious cases, angina can be triggered by drying yourself after a shower or shaving. Patients often first notice symptoms of discomfort when walking uphill or in a hurry. Many patients can still barely hold on to work, or even do physical labor, in the initial stage when symptoms occur, but when the disease progresses, they find it difficult to walk to and from get off work. Some cases are more likely to occur in cold weather or after drinking alcohol. The inducing effect of emotions is almost as important as exercise. Anger and anxiety are obvious triggers. Watching intense sports games can often induce angina pectoris. Driving a car and speaking in public are also common triggers of angina pectoris. In addition, angina pectoris during sexual intercourse is also very common.

4. The duration of angina pectoris is also quite specific. Most attacks of pain last for 2 to 3 minutes. It is rare for the pain to last less than 1 minute or longer than 15 minutes. The methods that can relieve angina are almost as specific as the factors that trigger it. If the condition is caused by fatigue, a short rest can relieve it. Similarly, mental relaxation can also relieve symptoms. Nitroglycerin can often stop an angina attack within 3 minutes. If such an effect is not achieved, the diagnosis should be reconsidered. If the pain persists for a long time and is not effective after nitroglycerin treatment, the possibility of myocardial infarction should be considered. In addition, angina attacks are sometimes accompanied by difficulty breathing, palpitations, nausea, sweating, and occasionally dizziness, but loss of consciousness is extremely rare.