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coronary artery spasm

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Coronary arteries

Alternative Names 
vasospastic angina, variant angina, Prinzmetal's angina

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.

What is going on in the body? 
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 arteriosclerosis. Vasospastic angina differs in that it can happen whether a person:
  • is active or resting
  • does or does not have clogged arteries from arteriosclerosis
When the spasms occur, blood flow to the heart lessens. This causes the pain and raises the risk of a heart attack.

What are the signs and symptoms of the condition? 
Symptoms of vasospastic angina are similar to those of typical angina: These symptoms occur:
  • at rest
  • during sleep
  • with or without physical exertion
What are the causes and risks of the condition? 
The coronary arteries and other blood vessels may constrict due to:
  • certain medications, such as vasopressin or ergonovine
  • cocaine
  • exposure to cold
  • high levels of stress
Sometimes, strenuous activity can bring on an attack.

What can be done to prevent the condition? 
Generally, nothing can be done to prevent the condition.

How is the condition diagnosed? 
A doctor 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 catheterisation can find clogged blood vessels.

Often, vasospastic angina can be diagnosed only after other possibilities have been excluded.

What are the long-term effects of the condition? 
A person with coronary artery spasms has a higher risk of: What are the risks to others? 
There are no risks to others.

What are the treatments for the condition? 
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:
  • eat a healthy diet, following the Australian Guide To Healthy Eating
  • exercise regularly
  • quit smoking
  • use alcohol in moderation
What are the side effects of the treatments? 
All medications have side effects. Medications used to treat coronary artery spasm may cause What happens after treatment for the condition? 
Uncomplicated cases are usually well controlled with heart medication.

How is the condition monitored? 
Monitoring includes:
  • blood tests
  • ECG tests
  • stress tests, or an ECG of the heart's function during exercise

A person should report any change in the pattern or severity of chest pains to his or her doctor right away.

Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne

Last Updated: 9/11/2004
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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