Which type of angina is associated with coronary artery spasm?

• A. Vasospastic angina
• B. Stable angina
• C. Unstable angina
• D. Ischemic angina

Answer: (A)

The concept being tested is that chest pain caused by a temporary narrowing of a coronary artery is due to spasm of the vessel. Vasospastic angina, also known as Prinzmetal angina, arises from transient smooth muscle contraction in a coronary artery, meaning blood flow is briefly reduced even if the heart’s demand isn’t high. This leads to episodic chest pain that can occur at rest and is often accompanied by ST-segment elevations on the ECG during the episode. It’s distinct from other types of angina: stable angina comes from fixed, atherosclerotic narrowing that limits flow during exertion; unstable angina results from a crisis of plaque rupture and thrombosis causing worsening ischemia; and ischemic angina isn’t the term used for this vasospastic mechanism. Therefore, the type associated with coronary artery spasm is the vasospastic form.