Difficulty in Diagnosing Prinzmetal's Angina

Prinzmetal's Angina, also known as variant angina is extremely difficult to diagnose.


The following abstract was kindly submitted to us by Dr Pankaj Kumar Mishra, a Cardiothoracic Surgeon located in the UK. Dr. Mishra's credentials and contact information. 

Patients with variant angina represent a diagnostic and therapeutic dilemma. Variant angina is a disease with various causes, variations in treatment guidelines and variable prognosis. In an era of robotic cardiac surgery and automatic cardioverter defibrillators, it is regrettable that we lack enough information on the optimal management of this entity. Lack of randomised trials and a tendency for spontaneous remissions makes interpretation of results difficult. We review the pathophysiology, presentation and recent developments in medical and surgical management of variant angina. Literature is full of conflicting data and it is difficult to make specific recommendations.

Read the entire text


Physicians as well as the general public are subject to a steady stream of misinformation about Prinzmetal's Angina

The internet is a wonderful source of information. It is used by the general public and by professional people as well. People rush to Google for information about medications, medical symptoms, disease names and the parts of the body.  If you want to know the names of all the bones in the hand, the nerves in your spinal column, the symptoms of a rare disease such as Barth Syndrome or Prinzmetal's Angina, or the side effects of a specific medicine, the internet will give it to you.

Physicians now commonly turn to their smart phones to check for details about something instead of going to books.

Unfortunately, the internet is full of misinformation.  The websites put up by even well known national organizations frequently google a subject for content on their website.  They don't realize that the source they have gone to has done the same thing and they got it from someone who had it wrong. This happens across the full spectrum of the internet.

During the time the APAA has been in existence we have received emails and phone calls from PA sufferers who had been to doctors working under a cloud of misinformation.  Doctors told them that they couldn't have PA because their attacks came at the wrong time of day or because they were the wrong gender or age or ethnic background to have PA.   Some were told that the condition is so rare that it was not even worth considering.

With so much mis-diagnosis we believe there is a very large group of people suffering from PA who don't have a clue as to the actual disease from which they are suffering.


PA is not a very rare disease. It is just very difficult to diagnose.  It may be happening in concert with all other types of angina and may also be the cause of death in many cases which are never accurately diagnosed because there is nothing to be found in an autopsy.

We have no idea of how many people die as a result of PA every year.