| ID | 70 |
|---|---|
| Name | PRINZ METAL ANGINA |
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| Management | Treatment: 1. Bed rest. 2. Sublingual nitroglycerine. 3. Isosorbide mononitrate or dinitrate. (Dose: as above). 4. Nifedipine or Amlodipine. (Dose: see in the thera-peutic section). 5. Surgery: if medical measures fail- PTCA. Caution: B-blocker should not be used, as it may worse it. Differential diagnosis: Angina vs Myocardial infarction: Angina Myocardial infarction 1. Site: Retrosternai, radiates to arm, 1. As for angina epigastrium & neck 2. Precipitated by exer-cise or emotion 2. Often no obvious precipitant 3. Relieved by rest & nitrates 3. Not relieved by rest & nitrates 4. Severity- mild to moderate 4. Usually severe 5. Anxiety- absent or mild 5. Severe anxiety 6. No increased sympathetic activity. 6. Increased sympathetic activity. |
| Introduction | Prinz Metal or Variant angina refers to cardiac pains occuring at rest and characterised by ST elevation (instead of ST depression), may be due to coronary artery spasm. |
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