Variant Angina Triggered by Exercise?

[johnkraus]

I recently suffered chest pains, received a cardo cath, and was told I had cardiac spasm, or variant angina, aka prinzmetal's angina.
I'm told this condition occurs at rest usually, which has been true for me. However an hour walk yesterday also brought on chest pains that nitro wouldn't relieve and thus sent me to the ER. To be told after 9 hours I was fine.
Does it make sense that exercise can bring on chest pain when one has variant angina or am I being misdiagnosed and  in fact have unstable angina?

[ed34]

By Cardio Cath do you mean an Angiogram? where a catheter is passed into the coronary arteries and dye is injected? If so, did they witness an artery in a spasm state?

Variant angina is usually associated with the heart being at rest and as you say, it could
be possible that you have unstable angina which can occur at any time.

[johnkraus]

Yes is was an angiogram. They witnessed the artery in spasm, injected nitroglycerin, and the artery calmed down. The heart itself was clean, and no major blockages where found requiring stents or further work.
But I do know the the spasms occur not just at rest but after exercise, thus the conundrum as far as definitions go. Is there something like unstable variant angina and if so is that different from unstable angina? I.e. does unstable angina always refer to the heart rather than the arteries contracting?

[ed34]

Apparently a spasm can occur
when the heart is not at rest but MOST spasms occur when the heart is relaxed. The
most common time is the early hours of the morning. Performing catheter
treatments on patients with this condition is risky because when the catheter
touches the artery wall, it often seems to trigger it to close up. It's almost like it's ticklish.

[ed34]

Oh I nearly forgot, Nitro doesnt normally have any effect, i.e. relieve, unstable angina.
As it did relieve yours, this tends to point towards it being variant. I suppose in reality
it must be difficult for cardiologists to determine which one it is until several tests have
been run.