Coronary artery spasm, also known as variant angina and Prinzmetal’s angina, is a short-term and unexpected health condition where one of the coronary arteries narrows in size. The spasm stops or slows blood flow in the artery which stops oxygen enriched blood from entering into a certain part of heart.
Coronary artery spasms occur due to tightening of the muscles in the walls of one or more of the coronary arteries. The spasm, causing narrowing of the artery, may be at just one place in the artery, and may give significant symptoms of a blockage. However, an angiogram may show a normal coronary artery. The symptoms of a blockage would only be present during times when the coronary artery is in spasm.
Causes of coronary artery spasm
Coronary artery spasm is fairly common in people who have high blood pressure or high cholesterol; this condition is also prevalent in people who smoke excessively. Other causes include:
Medications (some can cause tightening of the blood vessels)
Street drugs such as cocaine and amphetamines
Though any number of things can cause coronary artery spasms, some people have them for unknown reasons.
Symptoms of coronary artery spasm
Coronary artery spasms are very painful for some people; however, there are people who don’t have any symptoms at all. When there are no symptoms associated with coronary artery spasm, the spasms are called silent coronary artery spasms.
Many people who have symptoms associated with coronary artery spasms have chest pain, also known as angina. If a coronary artery spasm lasts for a significant amount of time, it can cause a cardiac arrest.
Other symptoms include:
Pain radiating to the left arm
The symptoms can occur at any time of day, and they often occur when you are at rest. The pain may be felt as pressure in the chest, or it may feel like tightening or a crushing sensation. When pain is felt, it is usually severe.
Diagnostic evaluation for coronary artery spasm
The various tests available for diagnosing coronary artery spasm include an EKG and Coronary angiography.
Treatment options for coronary artery spasm
The main objective of treatment for coronary artery spasm is to treat the chest pain and avoid a heart attack. Nitroglycerin is often prescribed to open the blood vessels, which reduces or eliminates the heart pain.
Your doctor may also prescribe some other medications, such as calcium channel blockers and beta blockers. Your doctor may also prescribe a combination of long-acting nitrates and calcium channel blockers. If you are on any of these heart medications, you should check with your pharmacist before adding any over-the-counter drugs to the mix. You should also be aware that some of these medications can be harmful if used with some recreational drugs.
Though, coronary artery spasm is a severe condition, treatment generally helps in controlling the symptoms. If you have coronary artery spasms you may be at high risk for a heart attack; therefore, it is important to report them to your doctor. If you have chest pain that won’t go away after taking nitroglycerine get emergency help right away. Your doctor will tell you how many times you can repeat the nitro before getting help. Most doctors will instruct you to get emergency help after the 3rd nitro tablet (1 pill every 5 minutes) has failed to relieve your chest pain.
If your pain is from angina, the nitroglycerine should relieve your pain, but if you are having a heart attack, nitroglycerine will not relieve the pain significantly. When your pain is not relieved after 15 minutes of taking nitro, this is a sign that you may be having a heart attack.
Your doctor may also advise you to make some lifestyle changes. For instance, if you smoke, you may be advised to quit. You may also be advised to eat a heart healthy diet and to get sufficient exercise. If you follow your doctor’s treatment plan and recommendations carefully, you may be able to avoid coronary artery spasms or greatly reduce their frequency.
Possible Complications of coronary artery spasm
One of the most frequent complications of coronary artery spasms are cardiac arrhythmias, which can cause a cardiac arrest and sudden death. If you think you might be having a heart attack, get emergency help right away. Don’t try to drive yourself to the hospital; if you are alone, dial 911.
How to prevent coronary artery spasm
Preventing coronary artery spasms may not always be possible; however, it helps to eat a low fat, heart healthy diet to reduce the risk of atherosclerosis, which may be a contributing factor for these spasms. If you are having coronary artery spasms, it helps to avoid illegal drugs, smoking, exposure to cold and stress situations; these factors are known to promote or aggravate coronary artery spasms