Alcohol can trigger angina in some patients. Stopping alcohol ingestion can prevent recurrences.
Features:
(1) episodes of angina are experienced following alcohol ingestion, sometimes by up to 11 hours
(2) no other explanation can explain the findings better
(3) variable cardiac arrhythmias associated with episodes
(4) stops if alcohol use is discontinued
(5) coronary angiography consistent with vasospasm
Mechanism: vasospasm triggered by the alcohol (Prinzmetal variant angina)
Possible contributory factors:
(1) concurrent smoking
(2) magnesium deficiency
(3) underlying coronary artery disease (certainty of vasospasm less than if normal)
(4) amount of alcohol ingested
