Review of Prinzmetal Angina (Nursing)

00:01 Now let's look at that really weird one, that variant angina, or prinzmetal angina.

00:06 That's caused by a vasospasm.

00:09 And because the vessel is -- spasming, you have supply ischemia issues.

00:14 So the pathophysiology, just to quickly remind you, remember, it's a coronary artery spasm. And that's because remember those little endothelial cells that we have around the linings, they have some kind of weird dysfunction going on.

00:27 Maybe there's damage or smooth muscle hyperactivity.

00:30 We're not exactly clear on why this happens in patients, but we're very clear that it does.

00:36 So it happens most often at night, which that's really creepy, isn't it? That's because you have a higher vagal tone at night, but this is not how you want to wake up, is it, with chest pain, but patients often report that's when they most often feel variant angina.

00:51 So, what's our strategy? Well, since it's a spasm, our goal is to increase the cardiac oxygen supply.

00:59 Best way to do that in a spasm is to be to try to relax that spasm, right? So the drugs we're going to use are calcium channel blockers.

01:08 We can also use organic nitrates and beta blockers are not our friends.

01:15 So I want you to star that point in your notes.

01:18 We don't use beta blockers for variant angina.

01:22 They won't help.

01:24 So we use calcium channel blockers and organic nitrates, but we do not use beta blockers with this type of chest pain.