Coronary artery spasm
Key points
- Coronary artery spasm is a temporary, abrupt, and focal (restricted to one location) contraction of the muscles in the wall of an artery in the heart, which constricts the artery.
- Coronary artery spasm is a cause of inadequate oxygen levels (ischemia) of the heart.
- An examination is usually inconclusive, but may indicate Atherosclerosis.
- The goal of treatment is to control chest pain and to prevent Heart Attack.
Alternative names
Variant angina; Angina - variant
Definition
Coronary artery spasm is a temporary, abrupt, and focal (restricted to one location) contraction of the muscles in the wall of an artery in the heart, which constricts the artery. This slows or stops blood flow through the artery during the spasm.
Causes, incidence, and risk factors
Coronary artery spasm is a cause of inadequate oxygen levels (ischemia) of the heart. It affects approximately 4 out of 100,000 people, and affects approximately 2% of patients with angina.
The arteries affected may be normal but much more often, they are "hardened" (atherosclerotic). Spasm may be "silent" - without symptoms - or it may result in stable angina or Unstable angina. The most typical manifestation of coronary spasm is variant angina (see below). Prolonged spasm may even cause a Heart Attack.
Coronary artery spasm may occur spontaneously, or it may be caused by exposure to cold, emotional stress, alcohol withdrawal, or vasoconstricting medications. Cocaine use and cigarette smoking can cause severe spasm of the arteries while at the same time increasing the energy requirements of the heart.
Variant angina is a type of Chest pain , probably involving coronary artery spasm, where the angina pain is triggered by rather unusual factors. It most often affects women under 50, but can also affect men.
Symptoms
The main symptom is angina (a type of chest pain), with these characteristics:
- Under the chest bone
- Described as squeezing, constricting, tightness, pressure, crushing - it is usually severe and may radiate to the neck, jaw, shoulder, or arm
- It often occurs at rest
- May occur at the same time each day, usually between midnight and 8:00 AM
- Pain lasts from 5 to 30 minutes
- Pain is relieved by nitroglycerin
- Syncope (loss of consciousness) can accompany the angina
Signs and tests
An examination is usually inconclusive, but may indicate Atherosclerosis. Coronary angiography may show spasm when the artery is injected with ergonovine, and may show fixed lesions, such as clot or atherosclerosis, which contribute to chest pain.
Frequently asked questions
What is coronary artery spasm?
Coronary artery spasm is a temporary, abrupt, and focal (restricted to one location) contraction of the muscles in the wall of an artery in the heart, which constricts the artery. This slows or stops blood flow through the artery during the spasm.
What are the risk factors for coronary artery spasm?
Coronary artery spasm is a cause of inadequate oxygen levels (ischemia) of the heart. It affects approximately 4 out of 100,000 people, and affects approximately 2% of patients with angina. The arteries affected may be normal but much more often, they are "hardened" (atherosclerotic). Spasm may be "silent" - without symptoms - or it may result in stable angina or Unstable angina. The most typical manifestation of coronary spasm is variant angina (see below). Prolonged spasm may even cause a Heart Attack. Coronary artery spasm may occur spontaneously, or it may be caused by exposure to cold, emotional stress, alcohol withdrawal, or vasoconstricting medications.
What are the symptoms of coronary artery spasm?
The main symptom is angina (a type of chest pain), with these characteristics:
- Under the chest bone
- Described as squeezing, constricting, tightness, pressure, crushing - it is usually severe and may radiate to the neck, jaw, shoulder, or arm
- It often occurs at rest
- May occur at the same time each day, usually between midnight and 8:00 AM
- Pain lasts from 5 to 30 minutes
- Pain is relieved by nitroglycerin
- Syncope (loss of consciousness) can accompany the angina
Written and revised by
David Cohen, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
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