Tuesday, April 05, 2011
ROCHESTER, Minn. — Gripping chest pain should always mean a quick trip to the emergency department, but the cause isn't necessarily a heart attack. It could be coronary artery spasm. The April issue of Mayo Clinic Health Letter covers this trigger of trouble and what it means for heart health.
A coronary artery spasm is a brief, temporary narrowing of the artery that supplies blood to the heart. The spasm can cause symptoms of angina — chest tightness or pressure — or a crushing, squeezing chest pain. While a spasm is not a heart attack, it can trigger one or start a life-threatening heart rhythm disturbance. Repeated episodes can impair heart function, setting the stage for heart failure.
Coronary artery spasm is most common in younger adults but it occurs in older adults, too, especially older women. The condition is typically diagnosed with an X-ray imaging test (coronary angiogram) after chest pain or other heart attack symptoms. If doctors don't find narrowed arteries or blockages associated with coronary artery disease, a coronary artery spasm is suspected. Further testing can confirm the diagnosis.
An absence of narrowed arteries doesn't necessarily mean all is well. Coronary artery disease is often present at the site of a coronary artery spasm. In the early stages of coronary artery disease, vessel walls undergo nearly imperceptible change. Cholesterol-laden plaques initially grow outward, without causing narrowing.
Initial treatment for coronary artery spasm focuses on underlying causes. For older adults, this includes addressing lifestyle factors that raise the risk of heart disease. Patients will be encouraged to stop using tobacco, maintain a healthy weight, eat a healthy diet and manage stress. Additional treatment may focus on controlling other risk factors such as high blood pressure, cholesterol and diabetes.
Many patients respond well to initial therapies, especially those with minimal coronary artery disease. Other options include placing a stent at the spasm site or implanting a defibrillator to stop heart arrhythmias.
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