Abstract: Objective To explore the clinical characteristics of variant angina pectoris, thus improving its diagnosis and treatment. Methods The clinical data of a patient with variant angina pectoris who was treated under the guidance of optical coherence tomography (OCT) were retrospectively analyzed. The clinical features of variant angina pectoris were analyzed by searching relevant articles in the CNKI, PubMed and Wanfang database with key words of “variant angina pectoris” and “OCT”. Results The male older patient presented with intermittent chest for more than 2 years and aggravated for more than 10 days was admitted. Electrocardiography on attack showed ST elevations in leads of II, III and arteriovenous fistula (AVF), and downwards of the remaining leads. The ST segment fell back after symptoms were relieved. The results of coronary angiography under the guidance of OCT showed a stenosis of 20%-30% in the proximal and middle segments of the right coronary artery, a stenosis of 70% in the second turn of the middle segment, and a stent shadow in the distal segment. Ergonovine stimulation test in the right coronary artery showed diffuse spasm, which was relieved after the treatment of nitroglycerin and sodium nitroprusside. Considering the repeated attacks of chest tightness, poor response to medication andintraoperative coronary spasm, the patient was managed by stent implantationin the right coronary artery.After stent implantation, symptoms of chest tightness disappeared with a good efficacy. Conclusion Disease characteristics and treatment of variant angina differ from those of coronary atherosclerosis, presenting a high rate of misdiagnosis. It is necessary to improve the vigilance and understanding of the disease. Timelyintracavitary imaging examination and provocation test contribute to a precise diagnosis and favor the selection of the optimal treatment and improvement of the prognosis.

Key words: optical coherence tomography, variant angina pectoris, coronary intervention