Prinzmetal ‘s Angina :also known as variant angina or angina inversa , occur in rest and related to spasm of coronary arteries.
Have intermittent coronary spasm at rest.
Vasoconstr due to platelet thrombaxane A 2 or decrease endothlin.
ECG show S-T segment elevation during stress.
It respond well to vasodilator ,nitroglycerin & calcium channel blockers.
Pathological finding in myocardium caused by angina
Stable & Prinzmetal’s angina do not cause any significant myocardium cell necrosis.
Unstable angina may associated with focal myocyte necrosis that repaired by foci of fibrosis
R/: Revascularization procedure: One method of treating patients with severe angina due to diffuse coronary disease is transmyocardial laser revascularization (TMR).
coronary blockage denoted by red arrow) can be treated by percutaneous interventions or bypass surgery, there are an increasing number of patients with diffuse coronary artery disease (fig. on right) that are not candidates for such interventions.
Heart failure (HF) is a condition in which a problem with the structure or function of the heart impairs its ability to supply sufficient blood flow to meet the body's needs
Myocardial infarction ( MI ) commonly known as a heart attack , is the interruption of blood supply to part of the heart, causing some heart cells to die. This is most commonly due to occlusion (blockage) of a coronary artery following the rupture of a vulnerable atherosclerotic plaque.