Coronary Artery Spasm

What is a coronary spasm?

Coronary spasm is a sudden and temporary narrowing or tightening of a small part of a coronary artery. (The coronary arteries are the arteries that bring blood to the heart.) When the spasm happens, your heart temporarily does not get enough oxygen and you feel a type of chest pain called angina.

This type of chest pain may also be called Prinzmetal's angina, atypical angina, or variant angina.

How does it occur?

Doctors don’t know why the spasms happen.

What are the symptoms?

Symptoms of coronary spasm include:

• Chest pain that feels like a strangling or heavy pressure on the chest.
• Pain that starts in the chest and spreads to the throat, arms (usually the left arm), jaws, and between the shoulder blades. The pain can also spread to the stomach and feel like an ulcer or indigestion.
• A feeling of tightness or heaviness in the chest.
• Nausea.
• Sweating.
• Lightheadedness.
• Trouble breathing.

How is it diagnosed?

Your healthcare provider will examine you and may order an ECG (electrocardiogram, also called an EKG). An ECG records your heart rhythms. The recording may show certain changes when you have pain. You may wear a small, portable ECG recorder called a Holter monitor to record your heart rhythm for 1 to 3 days.

You may also need a stress or treadmill ECG. During this type of ECG, the activity of your heart is recorded while you exercise on a stationary bike or treadmill.

You may need a coronary angiogram. This special X-ray uses a dye to make pictures of the arteries. It can show blockages in the arteries. Sometimes it can show areas of spasm. During the test, medicine may be injected into your arteries to start a spasm.

How is it treated?

The goal of treatment is to prevent or control symptoms. You and your healthcare provider will develop a treatment plan that includes:

• stopping the use of drugs that cause coronary spasm
• taking medicine to help prevent spasm
• reviewing your lifestyle and habits to reduce your risk for heart disease
• having frequent follow-up appointments to check your progress.

How long will the effects last?

The effects will last as long as the cause of the spasm exists or until the spasm responds to medicine.

How can I take care of myself?

To help take care of yourself:

• Avoid using drugs that cause spasms.
• Take your medicine as directed by your healthcare provider.
• Report new or changing symptoms right away.
• Learn how anxiety and stress affect you. Learn ways to cope with stress.

To help prevent problems with coronary spasms, reduce your risk for heart disease as much as possible by also:

• not smoking
• exercising regularly according to your healthcare provider's advice
• limiting caffeine and other stimulants
• maintaining a healthy weight
• eating foods that are low in cholesterol, low in saturated and trans fat, and high in complex carbohydrates and fiber.