Unstable angina / non ST elevation myocardial infarction prinzmetal's angina

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Overview of Prinzmetal's Angina in UA / NSTEMI

ACC / AHA Guidelines (DO NOT EDIT) [1]

Class I

1. Diagnostic investigation is indicated in patients with a clinical picture suggestive of coronary spasm, with investigation for the presence of transient myocardial ischemia and ST-segment elevation during chest pain. (Level of Evidence: A)

2. Coronary angiography is recommended in patients with episodic chest pain accompanied by transient ST segment elevation. (Level of Evidence: B)

3. Treatment with nitrates and calcium channel blockers is recommended in patients with variant angina whose coronary angiogram shows no or non obstructive coronary artery lesions. Risk factor modification is recommended, with patients with atherosclerotic lesions considered to be at higher risk. (Level of Evidence: B)

Class IIb

1. Percutaneous coronary intervention may be considered in patients with chest pain and transient ST segment elevation and a significant coronary artery stenosis. (Level of Evidence: B)

2. Provocative testing may be considered in patients with no significant angiographic CAD and no documentation of transient ST segment elevation when clinically relevant symptoms possibly explained by coronary artery spasm are present. (Level of Evidence: C)

Class III

1. Provocative testing is not recommended in patients with variant angina and high-grade obstructive stenosis on coronary angiography. (Level of Evidence: B)

See Also

Sources

  • The ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction [1]

References

  1. 1.0 1.1 Anderson JL, Adams CD, Antman EM; et al. (2007). "ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-Elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction) developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine". JACC. 50 (7): e1–e157. PMID 17692738. Text "doi:10.1016/j.jacc.2007.02.013 " ignored (help); Unknown parameter |month= ignored (help)

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