Not every severe chest pain is synonymous with a fat-clogged artery. In the most recent episode of the successful podcast “Medicina con Cabeza”, Dr. Carlos Yebra, renowned cardiology resident and passionate medical communicator, delves into a fascinating and sometimes frightening pathology: coronary vasospasm, better known as Prinzmetal’s Angina. HERE you can listen to the podcast.
Click on the photo to listen to the podcast
Unlike the traditional infarction we see in older patients with high cholesterol, Prinzmetal’s Angina occurs frequently in younger patients.
As Dr. Yebra explains, the problem is not a thrombus or a ruptured plaque, but a sudden and temporary “squeezing” of the coronary arteries.
“It is a transient vasospasm that produces reversible myocardial ischemia,” the specialist explains.
The most disturbing feature is that the patient arrives at the emergency room with ST-segment elevation (a sign of acute infarction) on the electrocardiogram, but within minutes, the trace magically normalizes when the pain ceases.
Patient profile: young people, smokers and nocturnal seizures.
Dr. Carlos Yebra, whose career is noted for simplifying complex medicine for professionals and students, points out that there are specific warning signs to suspect this condition:
Resting pain: Unlike common angina, this is not dependent on physical exertion.
Nighttime: Typically occurs in the early morning, awakening the patient due to cortisol spikes or adrenergic discharges.
Risk factors: It usually occurs in young males, smokers and, in some cases, associated with the consumption of substances such as cocaine or high levels of stress.
Diagnosis and danger of arrhythmias
One of the vital points Dr. Yebra touches on in this episode is clinical management.
Even if the patient is young and the pain disappears quickly with nitrates (vasodilators), one should not let one’s guard down.
“You have to monitor them because they are at risk for malignant ventricular arrhythmias,” he warns.
As for treatment, the expert clarifies that, while beta-blockers are used in a typical infarction, in vasospasm these could be counterproductive, with calcium antagonists being the main allies to regulate the smooth muscle tone of the artery.
With this episode, Dr. Carlos Yebra reaffirms why his podcast is an essential tool to “lose the fear of electros” and understand cardiology from the purest pathophysiology.
The episode is now available on all audio platforms, such as Apple Podcast and Spotify, where you can also listen to other titles promoted by QuéOnnda and Nueva Network, such as Renacer en el Duelo.
