Coronary artery spasms/Prinzmetal's a... - British Heart Fou...

British Heart Foundation

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Coronary artery spasms/Prinzmetal's angina


It was almost reassuring to read FluffyBee's post since my husband is still caught in a perfect storm trying to get a diagnosis. He has all the symptoms of the above but was told by a nurse from the rapid access chest pain clinic in a telephone assessment that they were not cardiac related since they occur at rest. He wrote to the consultant in charge quoting the NHS website that not all types of angina occur on exertion but the consultant just backed the nurse. His GP now simply quotes what they have said but has arranged an ECG & a BHP blood test for heart failure to 'reassure him' at the same time as saying the ECG won't show anything & that he does not have any symptoms of heart failure. He feel he has to go through with this farce but what next? Like FuffyBee, he has a spoken to a BHF nurse without success. Does anyone know what tests he should have ?

7 Replies
MilkfairyHeart Star

Where in the UK are you based?

Ask for your husband to be referred to one of the centres who are taking part in the PRIZE study a trial into a possible new medication to treat microvascular angina.

See my answer to Smileyian in Fluffybee's post

Hi he should have an angiogram, exercise test even though it happens at rest...just to be sure. Some cardiologists diagnose by injecting a medication which would cause a spasm if you have coronary artery spasms etc but mine went by my symptoms as he does not like doing the injection test. Find a cardiologist who knows about this condition. If you do find it is diagnosed then do not let them put him on beta blockers as it is contraindicated for this type of angina. He will probably be put on a calcium channel blocker and be given a gtn spray.. The BHF does have information on micro and vasospastic/CAS/Prinzemetal angina.

MilkfairyHeart Star in reply to livingwaters

Here are the links to the BHF information

Whilst in most cases beta blockers are not usually recommended if you have vasospastic angina it is sometimes prescribed.

Without a definitive diagnosis of either microvascular dysfunction or vasospastic angina it can be trail and error to get the best combination of medication that works best for each individual.

The latest research and the European Society of Cardiology consensus document on Ischaemia no obstructed coronary arteries (INOCA) recommends a pathway for diagnosing microvascular dysfunction and vasospastic angina during an angiogram by using a guide wire, an injection of adenosine and then acetylcholine.


See Milkfairy's posts.

Hi 45sue,

I had the same issues 18 months or so ago my GP was sure it was variant angina and referred me to a cardiologist at the chest pain clinic. Cardiologist told me off for even being there and dismissed me saying it was not heart related - didn't even do any test was literally in there 5 mins. My husband and I were speechless!

End of Feb this year same thing happened chest pains getting short of breath paramedics sent out numerous times and again GP convinced it was variant angina so another referral made to cardiology. This time (same cardiologist!) he relented as it had been 5 years since I last had an angiogram and performed another one which I had in June. This time he had to eat his words and was diagnosed - finally! I was dreading having to see him again due to previous experience he had been so rude and dismissive but I guess you could say it was Karma!!

I tried to go back to work but had to be signed off again for a month recently as chest pains got the better of me. Got new meds just hoping it settles as having more bad nights than good at the moment.

I totally understand the predicament you and your husband are left in all I can say is we are the best people to know our bodies and know when something is wrong and persevere and persist however frustrating.

I hope you and your husband get the answers you need.

All the best to you both xx

45sue in reply to Ninjanoo

Thank you , Ninjanoo & everyone for your helpful replies. My husband is not armed with information with which to request a second opinion.

45sue in reply to 45sue

Correction - I should have said he is now armed with info.

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