Vasospasm refers to the sudden contraction of the muscular walls of an artery. It causes the artery to narrow, reducing the amount of blood that can flow through it.

The tissue receiving blood from the artery may develop ischemia (injury due to lack of oxygen). If it goes on long enough, necrosis (cell death) will occur. Persistent vasospasm is called vasoconstriction.

Vasospasm can happen to an artery anywhere in your body. The most common areas where larger arteries are affected are:

The most common areas where small arteries and arterioles are affected are:

The symptoms of vasospasm depend on where in the body it occurs.

Cerebral artery vasospasm

Because this usually occurs after a bleed in the brain, the most common symptom is a worsening neurological condition 4 to 14 days after a bleed. The person may be less awake or less responsive. They may have signs that there has been more damage in the brain, such as a weak arm and leg, or loss of vision.

Coronary artery vasospasm

Lack of oxygen in the heart muscle causes chest pain called angina. Although it varies, it’s usually a pressure or squeezing sensation on the left side of your chest that may go up your neck or down your arm.

Angina due to vasospasm is different than angina from coronary artery disease because it usually comes on during rest instead of during exercise.

Vasospasm of the nipple

This condition causes a burning or sharp pain and itching in the nipple of a person who’s breastfeeding. It can happen shortly after breastfeeding or in between feedings.

The pain is due to blood returning to the nipple when the vasospasm stops. In someone with Raynaud’s phenomenon, it usually happens at the start of breastfeeding because the nipple has become cold.

Raynaud’s phenomenon

Raynaud’s phenomenon causes fingers and toes to become painful and numb when exposed to the cold. They may also tingle and throb. In addition, the fingers and toes change color, turning white during a spasm, and then changing to blue followed by deep red as the artery opens up again. The nose and ears may also be affected.

Raynaud’s phenomenon may affect about of women of childbearing age. Although it’s uncommon, the symptoms of burning or sharp pain and itching in the nipples can occur when Raynaud’s phenomenon causes vasospasm in the nipple of a breastfeeding woman.

The way in which nipples vasospasm in someone with Raynaud’s phenomenon differs from typical nipple vasospasm. For example:

  • it usually affects both nipples instead of one
  • the nipples change color during and after the spasm
  • symptoms of vasospasm in the hands and feet when exposed to the cold also occur
  • vasospasms occur at random times instead of after breastfeeding

Cerebral artery vasospasm

This vasospasm most often happens after an aneurysm in a blood vessel in the brain bursts, causing blood to build up in the space between the brain and the skull. This is called a subarachnoid hemorrhage (SAH).

According to the Brain Aneurysm Foundation, about 30 percent of people who have an SAH experience vasospasms.

Coronary artery vasospasm

A coronary vasospasm usually occurs without an obvious cause or trigger. It happens more often in people who have a cholesterol buildup in their coronary arteries (atherosclerosis).

However, except for smoking, people who have vasospasms are less likely to have the typical risk factors for coronary artery disease (like high blood pressure and high cholesterol) than people who have coronary artery disease.

Vasospasm of the nipple

This vasospasm usually happens when a baby isn’t latched on to the nipple firmly enough during breastfeeding.

It can also be caused by exposure to tobacco smoke, nipple trauma, and severe stress. When it occurs in women who have Raynaud’s phenomenon, it usually happens when the nipple is exposed to cold.

Raynaud’s phenomenon

In this condition, the small arteries in the hands and feet spasm when exposed to cold or during periods of stress. There are two types. The cause of the primary type is unknown (idiopathic). Secondary Raynaud’s phenomenon is due to another condition, such as scleroderma.

For vasospasm in large arteries, imaging studies and procedures that look at the arteries and the blood moving through them are the primary tests for diagnosis. Some of the these are:

  • Ultrasound with Doppler. This method looks at blood movement through blood vessels.
  • CT perfusion scan. This scan shows how much blood areas are getting.
  • Coronary or cerebral angiography. During this procedure, dye is injected into the artery and viewed with an X-ray that shows movement.

Doctors typically diagnose Vasospasm in small arteries by studying a person’s medical history and their symptoms. There are no tests specifically for Raynaud’s phenomenon or nipple vasospasm.

If the doctor thinks another condition may be causing Raynaud’s phenomenon, they may do blood tests looking for the cause.

Cerebral vasospasm

The main treatment is to increase blood flow to the brain, so that more oxygen gets to the injured area. A calcium channel blocker, called nimodipine, doesn’t stop vasospasms, but it improves neurological outcome.

Coronary artery vasospasm

Treatment is with medications that reduce or relieve vasospasm, including:

  • nitrates: to prevent or relieve vasospasm
  • calcium channel blockers: to reduce vasospasm by relaxing the arterial muscle

Vasospasm of the nipple

There are several treatments for this, including:

  • pain relief with nonsteroidal anti-inflammatory drugs, like ibuprofen or acetaminophen (Tylenol), which are safe to use while breastfeeding
  • nifedipine, a calcium channel blocker that opens up the arteries and is safe to use while breastfeeding
  • warm oil gently massaged on the nipple during a spasm to help the pain
  • calcium, magnesium, and vitamin B-6 supplements
  • supplements high in omega fatty acids, such as primrose oil and fish oil

Raynaud’s phenomenon

The first step in treating this condition is to avoid things that cause spasms, like smoking, excessive caffeine, and prolonged exposure to cold. There are some medications that can help, including:

Vasospasms reduce the amount of blood flowing to tissues in the body, so they have the potential to cause injury or cell death in the areas they supply blood to. This is especially true when large arteries in the brain or heart are affected.

However, there are ways to prevent or minimize each type of vasospasm. For vasospasm in small arteries and arterioles, avoiding triggers is the most important treatment.

Most people have a good outlook if they avoid things that trigger a vasospasm and follow their recommended treatment plan.

Cerebral vasospasm

Subarachnoid hemorrhages (SAHs) can’t usually be prevented. However, early treatment of an SAH decreases the risk that complications like vasospasms will occur.

Coronary artery vasospasm

A type of medication, called nitrates, is used to prevent coronary vasospasms. Cholesterol-lowering medications called statins may also prevent them. In addition, avoiding things that trigger spasms can help prevent them. Triggers include:

  • smoking
  • being out in cold weather
  • using illegal stimulant drugs, such as cocaine and methamphetamine
  • stress

Vasospasm of the nipple

Several things can be done to help prevent this. Some tips are:

  • ensure the baby is positioned properly during breastfeeding
  • keep the nipples warm while breastfeeding and afterwards
  • avoid potential triggers, such as smoking, caffeine, and high stress

Raynaud’s phenomenon

Wearing gloves and warm socks in the cold can help prevent symptoms. Avoiding triggers is also helpful. Triggers include:

  • smoking
  • high stress levels
  • rapidly going from a hot environment to a cold one
  • medications, like decongestants, that cause vasospasm