Case Reports and Reviews: Open Access

A Rare Presentation of Prinzemetal Angina in Makurdi Nigeria: Case Report and Review of The Literature

Okpara Ihunanya Chinyere, Agada Samuel Ali, Ijir Aondoyima, and Alonyenu Edwin Inalegwu

Abstract

Background: Prinzemetal angina is characterised by episodic chest pain at rest due to coronary artery vasospasm with transient ST segment elevation on the electrocardiogram and angiographically normal coronary arteries. In more severe cases, ST elevation may be followed by T-wave inversion for hours or days which eventually resolve. Rare complications of Prinzemetal angina include life threatening ventricular tachyarrhythmias, cardiogenic shock, severe heart failure and myocardial infarction. Case presentation: We report a case of a 41-year-old man who presented to the emergency department with severe chest pain, severe breathlessness and cardiogenic shock. Chest pain resolved following administration of nitrates. Result of electrocardiogram carried out after chest pain had subsided revealed Q wave in lead V1 and T-wave inversion in leads V1 – V4. Coronary angiography revealed normal coronary arteries. He was treated with losartan, antiplatelets, and statins with good results. He was discharged and followed up on above medications and has remained asymptomatic. Conclusion: Rare and lifethreatening presentations of Prinzmetal angina require immediate therapy. Further attacks of angina can be prevented using nitrates, calcium channel blockers, renin-angiotensin system inhibitors and statins.

Keywords: Prinzemetal angina, Coronary vasospasm, Cardiogenic shock.