USMLE prinzmetal angina precipitating factor

[iownmle]

Hey all:

so I am studying for step 2 and my qbank says precipitating factors for prinzmetal angina includes exercise, hyperventiliation, emotional stress. However, most prinzmetal angina episodes happen at middle of the night. So I am confused how the precipitating factors work. Is it that you work out in the afternoon like around 3 pm and then you are more likely to get prinzmetal angina in the middle of the night? Or does exercise only increase the likelihood of you getting angina episode right after working out?

---

Members don't see this ad.

 

[seminoma]

Precipitating factors and the classic presentation are separate things.

Completely unrelated analogy to help you understand. Most people sleep at night. Precipitating factors for sleeping are sleep deprivation, sedating drugs, etc. If I give you sedating drugs at 8am, you'll sleep all day. If I give you sedating drugs at night, you'll sleep all night. If I do nothing you'll probably sleep at night because that's what most people do.

Same concept with variant angina. Classically it occurs at night without any identifiable triggers, but if you're exposed to a precipitating/exacerbating factor in the morning you have a higher risk of experiencing symptoms in the morning that someone who isn't exposed to any precipitating factor.