While I guess were going to have to educate your doc a little bit.
The problem here is since Prinzmetal or aka Variant angina or aka vasospasms are a random occurrence and unless your hooked up to a EKG when they occur they are elusive.
So based on this one must turn to symptoms and reactions to certain drugs to lead you down the path to a positive diagnosis.
First let’s go over quickly what they are!
I’m sure anyone of who pushed ourselves a little to hard such as a real long fast walk or playing some sport have gotten a leg cramp or a spasm in a muscle.
Well one of the things that make an artery a artery is that the tube that carry’s the blood is surrounded by a muscle. This muscle it what regulates the size of the tube and varies the pressure inside. This goes into fluid dynamics and I’m not going there right now!
However that muscle like any other muscle when over used or conditions such as nourishment or a clot are present can in fact spasm. Just like a leg spasm or cramp it usually passes within a short period of time. But can reoccur if corrective action is not taken or proper treatment is not administered. One of the main components in keeping the heart arteries from spasming is Nitrous Oxide.
How do you get this? Well it’s produced normally by the endothiel cells which line the tube of the artery produce it as a byproduct and it’s reabsorbed back into the muscle of the artery causing it to relax. As one ages this process can be interrupted or the artery tube develops a build up which block the reabsorbtion process the muscle will then constrict or in the worst case get cranky and start to spasm. It’s also a problem where a vein is used for a bypass since veins don’t have endothiel cells and the body wants to know why and it crates a deficit of NO since it’s using it to try and entice this new tube to grow endothiel cells which the vein bypass can’t do.
Anyway you get the idea that something is messing up the balance of NO in the system and the arteries aren’t happy about the lack of NO and they spasm and cause pain.
This is where the Nitro dugs and supplements such Arginine or citrulline come into play. They add too what’s not there and relax the whole situation.
I did some searching and came up with these links that that explain this a little better as while as the reason that beta blockers don’t help!!
https://en.wikipedia.org/wiki/Prinzmetal%27s_anginahttp://cursoenarm.net/UPTODATE/contents ... e=see_linkhttp://www.bendomd.com/278-prinzmetal-a ... tment.htmlHope this helps in your understanding!
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research!