The coronary arteries are a pair of blood vessels that carry oxygen-rich blood to the heart muscles. A spasm in these arteries known as a vasospasm reduces blood flow to the heart. This causes a chest pain called angina.
Most often, vasospastic angina occurs while a person is at rest or it wakes a person from sleep. Typical angina is linked with physical activity and caused by fat deposits clogging the arteries, or atherosclerosis. Vasospastic angina differs in that it can happen whether a person:
When the spasms occur, blood flow to the heart lessens. This causes the pain and raises the risk of a heart attack.
The coronary arteries and other blood vessels may constrict due to:
Sometimes, strenuous activity can bring on an attack.
Symptoms of vasospastic angina are similar to those of typical angina:
These symptoms occur:
A healthcare provider may suspect coronary artery spasms based on a person's symptoms. A pattern of chest pain at rest, for example, is suspicious, especially if a person has no history of blocked coronary arteries or heart attack. However, some people with this disease also have blocked coronary arteries.
An electrocardiogram, or ECG may be normal between attacks. During attacks, the ECG may record changes that show a lack of blood flow to the heart. A procedure called a cardiac catheterization can find clogged blood vessels.
Often, vasospastic angina can be diagnosed only after other possibilities have been excluded.
Generally, nothing can be done to prevent the condition.
A person with coronary artery spasms has a higher risk of:
There are no risks to others.
If a person has severely blocked coronary arteries, surgery may stop the vasospasms. Those who have fewer symptoms and no coronary artery blockages respond well to heart medication.
A person should also:
All medications have side effects. Medications used to treat coronary artery spasm may cause
Uncomplicated cases are usually well controlled with heart medication.
A person should report any change in the pattern or severity of chest pains to his or her healthcare provider right away.
Author:Eric Berlin, MD
Editor:Coltrera, Francesca, BA
Reviewer:Vincent J. Toups, MD
Merck Manual 1999
Current Medical Diagnosis and Treatment 1996
Harrison's Principles of Internal Medicine 1991
Heart Disease: A Textbook of Cardiovascular Medicine, 1980