What is a coronary artery spasm?
Answer From Rekha Mankad, M.D.
A coronary artery spasm is a temporary tightening (constriction) of the muscles in the wall of one of the arteries that supplies blood flow to your heart muscle. This can narrow and decrease or even completely prevent blood flow to part of the heart muscle.
If the spasm lasts long enough, it can lead to chest pain (angina) and even a heart attack (myocardial infarction). These spasms are sometimes referred to as Prinzmetal's angina or variant angina. Unlike typical angina, which usually occurs with physical activity, coronary artery spasms often occur at rest, often between the hours of midnight and early morning.
Coronary artery spasms are more common in people with risk factors for heart disease, such as high cholesterol and high blood pressure, but the spasms can also happen in people who have no risk factors.
Coronary artery spasms may be triggered by:
- Tobacco use
- Exposure to cold
- Extreme emotional stress
- Use of illegal stimulant drugs, such as amphetamines and cocaine
Treatment of coronary artery spasms may include medications such as:
- Nitrates, which can relieve chest pain
- Calcium channel blockers, which can help reduce muscle tightening in your chest
- Statin medications, which not only lower cholesterol, but have other beneficial effects on your heart arteries to prevent spasms
You can reduce your risk of coronary artery spasms by quitting smoking and controlling high cholesterol and high blood pressure.
Sept. 09, 2015
- Hung MJ, et al. Coronary artery spasm: Review and update. International Journal of Medical Sciences. 2014;11:1161.
- Bonow RO, et al. Non-ST elevation acute coronary syndromes. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2015. http://www.clinicalkey.com. Accessed July 10, 2015.