How does variant angina typically present?

• A. Exertional chest pain
• B. Resting chest pain
• C. Nonexertional chest pain
• D. Pain only after physical activity

Answer: (C)

Variant angina, also known as Prinzmetal angina, is characterized by episodes of chest pain that typically occur at rest, often in cycles, and can happen during periods of emotional stress or at night. The pain is caused by coronary artery spasm rather than exertion or physical activity, which distinguishes it from typical exertional angina that is associated with increased physical demand on the heart.

Patients experiencing variant angina often describe the pain as occurring in a nonexertional context, frequently when they are at rest, and it may be unpredictable. This pattern can lead to significant distress and can occur even without any obvious trigger, distinguishing it from angina that occurs solely during physical activity. Therefore, the defining feature of variant angina is the resting chest pain that is not typically related to exertion, making the diagnosis oriented toward its unique presentation compared to other forms of angina.