Spasm of the coronary arteries . It is a temporary, sudden contraction of one of the coronary arteries (the arteries that supply blood to the heart ). The spasm slows or stops blood flow through the artery and deprives part of the heart of oxygenated blood. Coronary artery spasm is one of the causes of ischemia or oxygen insufficiency in the heart, affecting approximately 4 out of 100,000 people and about 2% of patients with angina .
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- 1 Alternative names
- 2 General considerations
- 3 Causes
- 4 Symptoms
- 5 Tests to detect it
- 6 Treatment
- 7 Forecast
- 8 Possible complications
- 9 Sources
Vasospastic angina, variant angina, or prinzmetal angina
This disorder differs from other types of angina in important ways. First, the other types of angina usually occur when the person is doing some activity, and in people who have coronary artery disease (CAD). Spasm of the coronary arteries occurs more often when the person is resting. In fact, it usually occurs at night during sleep. It also tends to occur more often in young patients with very little plaque buildup in the coronary arteries.
Coronary artery spasm occurs more frequently in people who smoke or have high cholesterol or high blood pressure . It can occur without cause or it can be triggered by:
- Alcohol withdrawal
- Emotional stress
- Exposure to cold
- Medicines that cause narrowing of the blood vessels ( vasoconstriction )
- Stimulant drugs like amphetamines and cocaine
Cocaine and cigarette use can cause severe spasms of the arteries and also increase the workload on the heart. In many people, coronary artery spasm can occur without any other cardiac risk factors, such as smoking , diabetes , high blood pressure, and high cholesterol. Spasm often occurs in the coronary arteries that have not hardened due to plaque buildup ( atherosclerosis.). However, it can also occur in arteries with plaque buildup. These spasms are due to a contraction (tightness) of the muscles of the arterial wall and occur in only one area of the artery. The coronary artery may appear normal during the exam, but it does not function normally. About 2% of patients with angina have spasm of the coronary arteries.
The main symptom is a feeling of pressure, crushing, or burning in the chest. This sensation usually lasts between 5 and 30 minutes. The person may also lose consciousness. In some cases there are no symptoms (“silent” spasm). Unlike angina that is caused by hardening of the coronary arteries, chest pain and shortness of breath often do not occur when a person walks or exercises.
Tests to detect it
Tests to diagnose coronary artery spasm may be:
- Coronary angiography
The goal of treatment is to control chest pain and prevent a heart attack. An episode of pain can be relieved by a medicine called nitroglycerin . The doctor may prescribe other medications to prevent chest pain. Long-term use of a group of medications called calcium channel blockers may be needed. The doctor may prescribe long-acting nitrates together with calcium channel blockers . Beta-blockers are another type of medicine that can be used; however, in some cases, they can be harmful, especially if used in conjunction with cocaine .
This disorder may be a sign that the person is at high risk for heart attacks or life-threatening irregular heart rhythms ( arrhythmias ). The prognosis is generally good if the patient follows her doctor’s treatment recommendations and avoids certain triggers.