Korean Circ J.  2008 Jan;38(1):66-68. 10.4070/kcj.2008.38.1.66.

Reversed Circadian Variation in Variant Angina

• Min HS
• Koo BK
• Kim MK
• Kim HL
• Kim HS

• KMID: 2225876
• DOI: http://doi.org/10.4070/kcj.2008.38.1.66

Abstract

It is known that there is a marked variation in the frequency of variant angina attacks according to the circadian rhythm. The attack frequency is usually highest in the early morning and lowest in the afternoon. We describe here a middle-aged woman with variant angina whose chest pain occurred only during daytime. Because of her job, she sleeps from noon to 6 pm, and she experienced chest pain only during 2 to 3 pm. These findings suggest that the alterations to the sleep and wake cycle can affect the circadian variation of variant angina.

Keyword

Variant angina; Circadian rhythm

MeSH Terms

Chest Pain
Circadian Rhythm
Female
Humans

Figure

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  Fig. 1 ECG obtained during the patient's chest pain shows ST-segment elevation in the inferior leads (A). These changes resolved completely with the administration of intracoronary nitroglycerine (B). ECG: electrocardiogram.

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  Fig. 2 Right coronary angiograms. Near total occlusion of the mid right coronary artery (A). Resolution of near total occlusion by the administration of intracoronary nitroglycerine (B).

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  Fig. 3 Intravascular ultrasound (IVUS) images. Concentric atherosclerotic lesions from spasm segment (A). The other segments showed no abnormalities (B).

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