What should you know about variant angina pectoris?

Variant angina, also called a form of angina pectoris, happens when a coronary artery briefly narrows because its muscle tightens. Episodes may occur at rest, often at a similar time of day, and may not follow physical exertion. The heart can still be affected even when a person feels well between episodes.

Chest tightness, pressure, or pain may be accompanied by sweating, nausea, breathlessness, or a feeling of weakness. High blood pressure and smoking can raise cardiovascular strain, but only an assessment can identify the cause of a particular episode. An electrocardiogram may capture changes during symptoms or support the wider assessment.

Seek a clinician’s assessment for suspected or newly changing symptoms. Keep a record of the time, duration, rest or activity, possible triggers, and associated symptoms. Use only the medicine prescribed for your episodes and follow the instructions for it; some medicines can worsen artery spasm or interact with treatment, so check before taking new products.

Your care plan may include medicines that relax coronary arteries and treatment of cardiovascular risks. Blood-pressure medication or statin therapy may be considered when relevant. Do not alter treatment because symptoms have stopped between episodes.

Call emergency services for chest pain that is severe, prolonged, frequent, or different from your usual episodes, especially with breathlessness, fainting, sweating, nausea, or pain spreading to the arm, jaw, back, or shoulder. Sit and rest while waiting, and do not drive yourself. A symptom occurring at rest should be taken seriously even if it settles.

Ask how variant angina is distinguished from other causes of chest pain, whether an electrocardiogram or other testing is appropriate, which medicines are safe, and exactly when to call emergency services. Ask whether blood pressure or cholesterol treatment is part of your plan.