What is a coronary artery spasm?
Answer From Rekha Mankad, M.D.
A coronary artery spasm is a temporary squeezing of one or more arteries that supply blood to the heart. The condition causes chest pain, called angina. During a coronary artery spasm, less blood flows to the heart.
Other names for coronary artery spasms are:
- Prinzmetal's angina.
- Vasospastic angina.
- Variant angina.
Coronary artery spasms are not due to clogged arteries, a common cause of angina. But the two conditions can occur together. Many people who have coronary artery spasms don't have heart disease risk factors such as high cholesterol or high blood pressure.
Very bad chest pain is the main symptom of coronary artery spasms. The pain may feel like:
- Burning.
- Fullness.
- Pressure.
- Squeezing.
- Pain also may be felt in the arms, neck, jaw, shoulder or back.
Call 911 or your local emergency number if you are having sudden or unexplained chest pain. A sudden, extreme coronary artery spasm can lead to a heart attack.
Coronary artery spasms are unpredictable but often happen at rest, usually overnight into early morning. This is different from typical angina, which tends to occur with physical activity.
Things that can cause a coronary artery spasm are:
- Smoking or using tobacco.
- Cold temperatures.
- Extreme emotional stress.
- Stimulant drugs such as amphetamines and cocaine.
Medicines can treat or prevent coronary artery spasms. Such medicines include:
- Nitrates. These medicines help prevent coronary artery spasms. They also can quickly ease chest pain.
- Calcium channel blockers. These medicines relax the arteries. They help lower the risk of coronary artery spasms.
Cholesterol medicines called statins may be used if there also is plaque buildup in the heart arteries.
If a coronary artery spasm causes a dangerously fast heartbeat, a device called an implantable cardioverter-defibrillator (ICD) may be needed. An ICD continuously checks the heartbeat. It delivers electric shocks, when needed, to correct the heartbeat.
Show References
- Picard F, et al. Vasospastic angina: A literature review of current evidence. Archives of Cardiovascular Diseases. 2019; doi:10.1016/j.acvd.2018.08.002.
- Libby P, et al., eds. Non-ST elevation acute coronary syndromes. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Elsevier; 2022. https://www.clinicalkey.com. Accessed April 25, 2024.
- Beltrame JF, et al. Vasospastic angina. https://www.uptodate.com/contents/search. Accessed April 25, 2024.
- Marchini F, et al. Shedding light on treatment options for coronary vasomotor disorders: A systematic review. Cardiovascular Drugs and Therapy. 2023; doi:10.1007/s10557-022-07351-x.
- Angina. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/angina/symptoms-causes/syc-20369373. Accessed April 25, 2024.
- Mankad R (expert opinion). Mayo Clinic. May 7, 2024.
- Prinzmetal's or Prinzmetal angina, variant angina and angina inversa. American Heart Association. https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain/prinzmetals-angina. Accessed May 8, 2024.
Original article: https://www.mayoclinic.org/diseases-conditions/angina/expert-answers/coronary-artery-spasm/faq-20058316