Inverse angina, also known as coronary artery vasospasm or variant angina, is a condition characterized by sudden, intense chest pain caused by temporary narrowing or spasms in the coronary arteries. This constriction reduces blood flow to the heart muscle, leading to symptoms similar to traditional angina but with different triggers and patterns.
Types:
- Prinzmetal’s Angina
- Coronary Artery Vasospasm
Causes of Inverse Angina:
- Smoking
- Stress
- Extreme cold temperatures
- Cocaine use
- Alcohol consumption
- Drug interactions (e.g., certain medications)
- Hormonal changes
- Excessive caffeine intake
- Emotional distress
- High cholesterol levels
- Thyroid disorders
- Lack of physical activity
- Diabetes
- Genetic predisposition
- Certain autoimmune diseases
- Chronic obstructive pulmonary disease (COPD)
- Sleep disorders
- Severe anemia
- Excessive use of decongestants
- Coronary artery abnormalities
Symptoms of Inverse Angina:
- Sudden, severe chest pain
- Chest discomfort or pressure
- Shortness of breath
- Sweating
- Nausea or vomiting
- Dizziness or lightheadedness
- Fatigue
- Palpitations
- Pain radiating to the neck, jaw, shoulder, or arm
- Anxiety
- Feeling of impending doom
- Fainting or syncope
- Difficulty swallowing
- Abdominal pain
- Heartburn or indigestion
- Weakness
- Irregular heartbeat
- Difficulty speaking
- Vision changes
- Loss of consciousness
Diagnostic Tests for Inverse Angina:
- Electrocardiogram (ECG/EKG)
- Echocardiogram
- Exercise stress test
- Coronary angiography
- Cardiac MRI
- Holter monitor
- Blood tests (e.g., cardiac enzymes, lipid profile)
- Chest X-ray
- Coronary computed tomography angiography (CTA)
- Tilt table test
- Radionuclide stress test
- Ambulatory ECG monitoring (event recorder)
- Transesophageal echocardiography (TEE)
- Coronary calcium scan
- Myocardial perfusion imaging
- Coronary flow reserve measurement
- Intracoronary ultrasound (IVUS)
- Endothelial function testing
- Cardiac catheterization
- Genetic testing
Treatments for Inverse Angina:
- Nitroglycerin or other vasodilators to relieve spasms
- Calcium channel blockers (e.g., diltiazem, verapamil)
- Nitrates for acute episodes
- Beta-blockers to reduce heart rate and blood pressure
- Statins to lower cholesterol levels
- Lifestyle modifications (e.g., smoking cessation, stress management)
- Avoiding triggers (e.g., cold weather, certain medications)
- Oxygen therapy
- Antiplatelet medications (e.g., aspirin, clopidogrel)
- Angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs)
- Coronary artery bypass grafting (CABG)
- Percutaneous coronary intervention (PCI) with stent placement
- Implantable cardioverter-defibrillator (ICD) for high-risk patients
- Cardiac rehabilitation program
- Weight management
- Regular exercise regimen
- Dietary changes (e.g., low-sodium, heart-healthy diet)
- Stress reduction techniques (e.g., yoga, meditation)
- Beta-adrenergic agonists
- Potassium channel blockers
- Anti-inflammatory medications
- Pain management strategies
- Anti-anxiety medications
- Antidepressants
- Sleep apnea treatment (e.g., continuous positive airway pressure – CPAP)
- Blood pressure control
- Monitoring and treating other comorbid conditions (e.g., diabetes)
- Endoscopic thoracic sympathectomy (ETS)
- Radiofrequency ablation
- Psychological counseling or therapy
Drugs Used in Treating Inverse Angina:
- Nitroglycerin
- Diltiazem
- Verapamil
- Amlodipine
- Isosorbide dinitrate
- Nicorandil
- Ranolazine
- Metoprolol
- Atorvastatin
- Clopidogrel
- Aspirin
- Ramipril
- Losartan
- Nebivolol
- Propranolol
- Nifedipine
- Felodipine
- Atenolol
- Bisoprolol
- Ivabradine
Surgical Procedures for Inverse Angina:
- Coronary artery bypass grafting (CABG)
- Percutaneous coronary intervention (PCI) with stent placement
- Endoscopic thoracic sympathectomy (ETS)
- Radiofrequency ablation
- Coronary artery angioplasty
- Implantable cardioverter-defibrillator (ICD) placement
- Left cardiac sympathetic denervation (LCSD)
- Myectomy
- Ablation therapy
- Heart transplant
Conclusion:
Inverse angina, though relatively rare, can significantly impact one’s quality of life and requires prompt diagnosis and appropriate management. Understanding its causes, symptoms, diagnostic tests, treatments, drugs, and surgical options is essential for both patients and healthcare providers to effectively address this condition and improve outcomes. Early intervention and comprehensive care can help alleviate symptoms, prevent complications, and enhance overall well-being.
Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, previous medical history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. Thank you for giving your valuable time to read the article.
Angina Inversa
