What is a coronary artery spasm?

Coronary artery spasm is a sudden narrowing of a small part of a coronary artery that lasts only a short time. The coronary arteries are blood vessels that bring blood to the heart muscle. When the spasm happens, it narrows the artery and causes blood to slow or stop flowing through it. When the spasm stops, the artery and blood flow return to normal.

This rare condition may also be called Prinzmetal’s angina, atypical angina, or variant angina.

What is the cause?

The exact cause of coronary artery spasm is unknown. You are more likely to have coronary artery spasms if you:

• Are exposed to cold weather
• Are under a lot of stress
• Take medicines that cause your blood vessels to narrow or tighten
• Smoke
• Use illegal drugs, such as cocaine

What are the symptoms?

The symptoms of coronary artery spasm are similar to angina caused by heart disease, such as chest pain or pressure, squeezing, or fullness in the center of your chest that lasts more than a few minutes, or goes away and comes back (may feel like indigestion or heartburn). There may also be pain or discomfort in one or both arms or shoulders, or in your back, neck, jaw, or stomach

Unlike heart disease, the symptoms usually happen while you are resting during the night or in the early hours of the morning. The symptoms are often severe, but can be treated with medicine.

Many people with coronary artery spasms also have heart disease. Call 911 or your local emergency services right away if you have symptoms of a heart attack. The most common symptoms include:

• Chest pain or pressure, squeezing, or fullness in the center of your chest that lasts more than a few minutes, or goes away and comes back (may feel like indigestion or heartburn)
• Pain or discomfort in one or both arms or shoulders, or in your back, neck, jaw, or stomach
• Trouble breathing
• Breaking out in a cold sweat for no known reason
• If your provider has prescribed nitroglycerin for angina, pain that does not go away after taking your nitroglycerin as directed

Along with these symptoms, you may also feel very tired, faint, or sick to your stomach.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

• Blood tests
• An ECG (also called an EKG or electrocardiogram), which measures and records your heartbeat. You may have an ECG while you are resting or while you exercise on a treadmill. You may also be asked to wear a small portable ECG monitor for a few days or longer.
• A coronary angiogram, which is a series of X-rays taken after your healthcare provider injects a special dye into your blood vessels to look for narrowing, weakness, or blockages in the coronary arteries.

How is it treated?

The goal of treatment is to prevent or control symptoms. You and your healthcare provider will develop a treatment plan that includes:

• Taking medicine to help prevent and treat spasms
• Stopping the use of medicines or illegal drugs that cause coronary artery spasm
• Quitting smoking if you are a smoker
• Making diet changes and starting an exercise program to reduce your risk for heart disease

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Try to keep a healthy weight. If you are overweight, lose weight.
• Eat a healthy diet. Avoid foods high in cholesterol, saturated fat, and trans fat. Avoid rich foods or large meals if angina comes on after a heavy meal.
• Stay fit with the right kind of exercise for you. A healthy goal for most adults is to exercise for 2 hours and 30 minutes or more each week. You don’t need to do 30 minutes of activity all at once. You can do shorter periods, at least 10 minutes each time. Exercise according to your healthcare provider’s instructions. Slow down or take rest breaks if angina comes on with exertion.
• If you smoke, try to quit. Talk to your healthcare provider about ways to quit smoking.
• Have your blood pressure checked regularly. High blood pressure increases your risk for heart disease.
• Try to get at least 7 to 9 hours of sleep each night.
• Learn ways to manage stress.

Ask your provider:

• How and when you will hear your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.