The coronary arteries are a pair of blood vessels that carry oxygen-rich blood to the heart muscles. A spasm in these arteries known as a vasospasm reduces blood flow to the heart. This causes a chest pain called angina.
Most often, vasospastic angina occurs while a person is at rest, or it wakes a person from sleep. This is in contrast to typical angina caused by clogged arteries (atherosclerosis), which more often comes on with exercise. Vasospastic angina can, however, happen whether a person is active a resting and regardless of the presence of atherosclerosis.
When the spasms occur, blood flow to the heart is reduced. This causes the pain and raises the risk of a heart attack.
Symptoms of vasospastic angina are similar to those of typical angina: chest painshortness of breathrapid heartbeats called palpitations
These symptoms occur: at restduring sleepwith or without physical exertion
The coronary arteries and other blood vessels may constrict due to: certain medications, such as vasopressin or ergonovinecocaineexposure to coldhigh levels of stressnicotine
Sometimes, strenuous activity can bring on an attack.
Generally, nothing can be done to prevent the condition.
A healthcare provider may suspect coronary artery spasms based on a person's symptoms. A pattern of chest pain at rest, for example, is suspicious, especially if a person has no history of blocked coronary arteries or heart attack. An electrocardiogram (ECG) may be normal between attacks. During attacks, the ECG may record changes that show a lack of blood flow to the heart. A procedure called a cardiac catheterization can find clogged blood vessels. Often, vasospastic angina can be diagnosed only after other possibilities have been excluded.
A person with coronary artery spasms has a higher risk of: irregular heart rhythms, or arrhythmiasheart attacksudden death
There are no risks to others.
If a person has severely blocked coronary arteries, surgery may stop the vasospasms. Those who have fewer symptoms and no coronary artery blockages respond well to heart medication.
A person should also: eat a healthy diet, following the Food Guide Pyramidexercise regularlyquit smokingavoid excessive use of alcohol
All medications have side effects. Medications used to treat coronary artery spasm may cause headachefatiguesleep disorders such as insomniadizzinessserious arrhythmias
Uncomplicated cases are usually well controlled with heart medication.
Monitoring includes: blood testsECG testsstress tests, or an ECG of the heart's function during exercise
A person should report any change in the pattern or severity of chest pains to his or her healthcare provider right away.
Merck Manual 1999
Current Medical Diagnosis and Treatment 1996
Harrison's Principles of Internal Medicine 1991
Heart Disease: A Textbook of Cardiovascular Medicine, 1980