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Prinzmetal's Variant Angina A Syndrome Apart or Another Clinical Presentation of Atheromatous Heart Disease

Robert A. Chahine, MD
Arch Intern Med. 1979;139(1):26-27. doi:10.1001/archinte.1979.03630380014007.
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Since Prinzmetal and associate's first description,1 variant angina has remained an interesting subject for speculation and research and has become recently the focus of increased attention, resulting from the documentation of coronary artery spasm as the mechanism underlying the resting chest pain attacks.2,3 Consequently, more patients have been examined extensively.4-12 A review of the angiographic findings and the postmortem observations, when available, in these cases, suggests that a reexamination of our concepts of this entity may be warranted.

This form of angina is characterized by attacks of chest pain, which occur usually at rest, with accompanying ST segment elevation in the ECG leads corresponding to the ischemic area. In the original cases reported by Prinzmetal et al, the dominant postmortem finding was marked narrowing of a single large coronary artery.1 Subsequent reports recognized many patients with variant angina and angiographically normal coronary arteries9,13 and a


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