Is Variant Angina the Coronary Manifestation of a Generalized Vasospastic Disorder?

IN VARIANT angina, myocardial ischemia is caused by transient coronary-arterial spasm.^1,2 Although altered adrenergic activity has been proposed as the cause of coronary spasm^3,4 and high circulating thromboxane levels are found in patients with variant angina, ⁵ the true cause of the syndrome is unknown. The prodromal phase of migraine is caused by inappropriate vasoconstriction of cranial arteries, ^6,7 and enzymatic markers of cerebral ischemia can be detected in the cerebrospinal fluid after an attack.⁸ As in variant angina, abnormal platelet function has been described in migraine.^9,10 In spite of a variety of known triggering factors, the cause of migraine has not.