What causes Prinzmetal angina pain?

Prinzmetal angina, also known as variant angina, is characterized by episodes of chest pain due to transient ischemia of the heart muscle. The primary cause of this type of angina is vasospasm, which refers to a sudden and temporary constriction of the coronary arteries. This vasospasm can occur at rest or during sleep and leads to reduced blood flow and oxygen supply to the myocardium, resulting in the characteristic chest pain.

In the context of Prinzmetal angina, the spasm can affect either a single coronary artery or multiple arteries, but the underlying mechanism is the same: the vasospasm causes a significant decrease in perfusion, leading to ischemic conditions. This can happen even in individuals without significant stenosis in their coronary arteries, making it distinct from other forms of angina that are usually related to physical exertion or chronic atherosclerotic changes. Recognizing the role of vasospasm is crucial in understanding the pathophysiological process behind Prinzmetal angina and its management.