Prinzmetal's Variant Angina Associated With Subarachnoid Hemorrhage: A Case Report

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Abstract
Prinzmetal's variant of angina oc curred in a 48-year-old man who sus tained two attacks of subarachnoid hem orrhage within 10 days. The first anginal pain started at the same time that the second cerebrovascular accident devel oped, but subsequent anginal episodes were not accompanied by other symp toms or signs that indicated new devel opment of subarachnoid hemorrhage. Twelve days later, when nuchal rigidity was fairly improved, the episodes of chest pain ended. A vasospasm of the large coronary arteries—probably due to the derangement of the autonomic ner vous system caused by subarachnoid hemorrhage—was presumed to contrib ute to the occurrence of the variant an gina. Based on this case and on review of the literature, we propose that coronary arterial spasm is one of several causes of the cardiac changes seen in subarachnoid hemorrhage.

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