Coronary Artery Spasm

Written by Kristeen Moore | Published on August 30, 2012
Medically Reviewed by Brenda B. Spriggs, MD, MPH, FACP

What is a Coronary Artery Spasm?

A coronary artery spasm is characterized by the tightening of muscles within the arteries of the heart. Blood can’t flow through these narrowed arteries and as a result, the heart receives less blood oxygen. Coronary artery spasms are brief and temporary, but they can potentially lead to further heart complications. This symptom is also linked to other conditions of the heart, such as high cholesterol or hypertension (high blood pressure).

Coronary artery spasms may also be referred to as coronary artery contractions.

Recognizing Coronary Artery Spasms

Many coronary artery spasms go undiagnosed because they may not cause any noticeable symptoms in some patients. At most, such patients may notice occasional light chest pain. The danger in this is that the contractions can eventually cause heart attacks.

On the flip side, other patients may detect symptoms of a coronary artery spasm. Common symptoms may include:

  • chest pain (angina)
  • pain on the left side of your chest
  • chest tightness
  • feeling of constriction

You may even experience pain that spreads from the chest to your arms, neck or jawbone.

You may suspect coronary artery spasms if you have pain in the chest that:

  • occurs exclusively during rest
  • lasts from five minutes to as long as 30 minutes at a time
  • occurs most often at night or early morning

Causes of Coronary Artery Spasms

Hypertension and high cholesterol are the most common causes of these spasms.

According to the National Institutes of Health, two percent of angina patients also experience these symptoms (NIH, 2012).

Coronary artery spasms may occur in patients with plaque buildup in the arteries. This condition is also called atherosclerosis.

Risk Factors

People at risk for heart disease are also at a higher risk for coronary artery spasms. In fact, high cholesterol and hypertension can directly increase your risk of arterial constriction. Other activities that place you at higher risk of coronary artery spasms include:

  • smoking
  • excess use of stimulants
  • illegal drug use (especially cocaine)
  • extreme stress
  • extreme cold
  • alcohol withdrawal

If you have a history of coronary artery spasms, you should also take steps to minimize such risk factors. Exposure to triggers can increase your risk of future spasms.

Testing for Coronary Artery Spasms

A coronary artery spasm indicates that there is trouble brewing in the heart. For this reason, your doctor will likely order a variety of tests. These provide a clearer picture of the heart and help your physician put together a treatment plan. Diagnostic imaging tests may include:

  • electrocardiogram (ECG or EKG) to measure electrical activity within the heart
  • echocardiogram to measure sound waves to make a moving image
  • coronary angiography to visually measure blood flow through the heart

Once your doctor is able to detect the precise problems with your heart, he or she can then recommend an appropriate treatment plan. Since there are many heart ailments, imaging tests are helpful in providing the visual detail that is critical to making an accurate diagnosis.

Treatment of Coronary Artery Spasms

Treatment for coronary artery spasms aims to relieve chest pain. This mainly involves prescription medications such as:

  • nitrates, which can help dilate arteries and relax artery walls. Nitrates may be prescribed both as a long-term medication and as a pill to have on hand, should an episode occur.
  • L-arginine, a dietary supplement that can prevent spasms,
  • calcium channel blockers can reduce chest tightness by relaxing arterial muscle. This medication may be taken on a long-term basis.

Another goal is to prevent heart attacks. To achieve this, you may need medications to reduce cholesterol or blood pressure. For example, statin medications can reduce cholesterol, which may result in the treatment goal of fewer coronary artery spasms.

During treatment, you might also consider eating a low-fat, lower sodium diet. You should also quit smoking.

Potential Complications of Coronary Artery Spasms

While a coronary artery spasm is brief, it can have lasting consequences. When left untreated, coronary artery spasms can increase in frequency and may lead to:

  • heart arrhythmias (too fast or too slow heart rate)
  • heart attacks (complete blockage of blood flow to heart)
  • cardiac arrest
  • death

Outlook for Patients With Coronary Artery Spasms

Coronary artery spasm is most often considered a chronic condition. This means that the condition will last a long time and won’t go away on its own. However, the outlook for spasms is good if you follow a sound treatment plan.

Preventing atherosclerosis can also reduce the chances of experiencing coronary artery spasms. Lifelong heart-healthy habits, such as a consistent low-fat diet and regular exercise, can decrease your risk for cardiovascular disease. Always follow your doctor’s orders to help prevent further complications.

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