Medicine · Ischemic Heart Disease (Presentation, ECG, Complications, Management)

A 45-year-old man presents with episodic chest pain occurring exclusively at rest, often between midnight and early morning. During an episode, ECG shows transient ST-segment elevation that resolves spontaneously. Which mechanism is responsible for this condition?

  • A Coronary artery vasospasm
  • B Plaque rupture with thrombus formation
  • C Increased myocardial oxygen demand
  • D Microvascular dysfunction
Correct answer: A. Coronary artery vasospasm

Explanation

Prinzmetal angina is caused by transient coronary artery vasospasm, leading to transmural ischemia and transient ST-segment elevation. It typically occurs at rest, often at night, and is not related to exertion or plaque rupture. Calcium channel blockers are the mainstay of treatment for this condition.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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