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Coronary Artery Spasm

Overview

During a coronary artery spasm, muscles in a section of artery wall squeeze together and narrow, causing a temporary constriction of blood and oxygen flow to the heart. The spasm itself is not always severe or painful, but it can lead to serious problems, including heart attack, irregular heartbeat or death.

  • Symptoms

    • Chest pain under the sternum or on the left side
    • Sensations in the chest such as burning, squeezing, pressure or tightness
    • Spasms that occur at the same time each day, often in the early morning
    • Spasms that occur during rest rather than when exercising

    Some people experience no symptoms. For others, symptoms can be painful and last from a few minutes to a half hour or more. The longer symptoms last, the higher the risk of heart attack.

  • Prevention

    • Do not smoke.
    • Commit to a heart-healthy lifestyle.
    • Get regular checkups and work with your physician on ways to reduce high cholesterol, lower high blood pressure, lose excess weight, reduce stress and avoid diabetes and other chronic diseases.
  • Risk Factors

    • High blood pressure
    • High cholesterol
    • Smoking

    Triggers may include alcohol withdrawal, emotional stress, exposure to cold temperatures and use of stimulant drugs such as cocaine or amphetamines

  • Diagnosis

    Echocardiogram. This imaging test uses ultrasound technology to show the heart valves and blood flow.

    Electrocardiogram (ECG). An ECG test that shows the pattern of electrical activity involving a patient’s heartbeat may reveal irregular heart rhythms as an indication of possible coronary artery spasm.

    Cardiac catheterization. This procedure involves threading a catheter tube from a blood vessel in the arm, groin or neck to the heart and using it to inject dye into the blood vessels to make them visible on special X-rays called angiograms.

    Provocative testing. If needed for differential diagnosis, specific agents may be introduced to trigger a spasm for close study.

  • Treatment

    • Medication therapy may be used to reduce chest pain and lower the risk of heart attack. Options include calcium channel blockers, nitrates and statins.
    • Patient education may include ways to identify and avoid coronary artery spasm triggers such as smoking, stimulant use and exposure to cold or stress.
    • More invasive procedures may be required if lifestyle changes and medications do not lead to the desired results. These could extend to bypass surgery.
  • Follow-up Care

    • Patients should avoid tobacco use and other potential triggers.
    • Patients should follow physician direction regarding use of any prescribed medications, including taking the full dose for the designated period.