BACKGROUND
Variable angina pectoris is a special type of unstable angina pectoris, the pathological basis of which is coronary artery spasm, resulting in rapid myocardial ischemia and hypoxia. This spasm may be related to autonomic nervous dysfunction, coronary endothelial cell dysfunction, inflammation, genetics, and other factors. Here, we focus on the association between autonomic dysfunction and variable angina in young-onset type 2 diabetes and differentiation of its variant, angina pectoris, from early acute myocardial infarction.
CASE REPORT
We present the case of an adolescent patient with type 2 diabetes who was admitted to the hospital due to chest pain. After completing electrocardiography and finding transient ST-segment elevation, the patient underwent emergency coronary angiography without significant vascular stenosis and was diagnosed with variant angina pectoris. The patient was then treated with hypoglycemic drugs and vasospasm-improving drugs.
CONCLUSIONS
For families with a history of diabetes, it is critical to get the children of the sick parent or relative to the hospital in time for proper diagnostic testing. Upon confirmation of the disease, immediate medical intervention is advised to mitigate the risk of serious cardiovascular issues such as autonomic dysfunction related to vascular spastic angina pectoris. Second, it is difficult to distinguish between variable angina pectoris and early acute myocardial infarction, so coronary angiography should be performed as early as possible to avoid delayed treatment.

Keywords: Diabetes Mellitus; Coronary Vasospasm; Angina Pectoris, Variant; Autonomic Nervous System