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April 15, 1974

Prinzmetal Variant of Angina Pectoris

Author Affiliations

Hahnemann Medical College and Hospital Philadelphia

JAMA. 1974;228(3):342-343. doi:10.1001/jama.1974.03230280044034

In 1959, Prinzmetal et al1 described a variant of angina pectoris. Although it caused chest discomfort similar in quality and location to that described by Heberden, it differed in the following respects: (1) Chest pain began most commonly at rest or with ordinary activity (not with exertion), (2) prominent ST elevation occurred during episodes of chest pain and the electrocardiogram was typically normal in the absence of pain, (3) exercise tests were frequently negative, (4) there was single coronary artery disease with a focal lesion, (5) arrhythmias, commonly ventricular tachycardia or conduction disorders, or both, occurred during the pain, and (6) frequently, myocardial infarction ensued in the area of the heart corresponding to the ST segment elevation. Angina was rare after the myocardial infarction.

Subsequent reports from other investigators confirmed and amplified these initial diagnostic features, eg, the cyclical nature of the pain; its frequent mimicry of coronary insufficiency