Which statement best describes Prinzmetal angina?

Which statement best describes Prinzmetal angina?

• A. ST elevations due to coronary vasospasm
• B. Chest pain occurs with exertion
• C. Is caused by fixed atherosclerotic stenosis
• D. Responds best to beta-blockers

Answer: (A)

Prinzmetal angina is defined by episodic chest pain caused by transient coronary vasospasm, which temporarily reduces blood flow and produces transmural ischemia. During these spasm episodes, the ECG often shows ST-segment elevations that resolve once the spasm subsides. The pattern is classically at rest, sometimes nocturnally, and is best managed with vasodilators such as nitrates and calcium channel blockers. This description aligns with the statement that chest pain is due to ST elevations from coronary vasospasm. In contrast, pain due to fixed atherosclerotic narrowing tends to occur with exertion and is not associated with transient ST elevations during episodes. A fixed stenosis isn’t the culprit in Prinzmetal angina, and beta-blockers aren’t the preferred treatment; they can even worsen vasospasm in some patients, whereas vasodilators are more effective.

Prinzmetal angina is defined by episodic chest pain caused by transient coronary vasospasm, which temporarily reduces blood flow and produces transmural ischemia. During these spasm episodes, the ECG often shows ST-segment elevations that resolve once the spasm subsides. The pattern is classically at rest, sometimes nocturnally, and is best managed with vasodilators such as nitrates and calcium channel blockers.

This description aligns with the statement that chest pain is due to ST elevations from coronary vasospasm. In contrast, pain due to fixed atherosclerotic narrowing tends to occur with exertion and is not associated with transient ST elevations during episodes. A fixed stenosis isn’t the culprit in Prinzmetal angina, and beta-blockers aren’t the preferred treatment; they can even worsen vasospasm in some patients, whereas vasodilators are more effective.