A coronary artery spasm happens when the walls of blood vessels squeeze together, causing a part of the blood vessel to narrow.

The spasm itself is not always severe or even painful. Sometimes, however, it can lead to serious problems, including chest pain, heart attacks, or even death.

Accurately detecting and diagnosing the condition can pose a challenge for healthcare teams. Many different things can cause heart disease and chest pain, so it can be difficult for doctors to single out coronary artery spasms.

There are many options available to help treat the symptoms and the underlying cause.

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A coronary artery spasm is also known as vasospastic angina or prinzmetal angina.

A coronary artery spasm occurs when a segment of an artery, which carries blood to the heart, tightens and narrows.

As the artery spasms, the heart is forced to work harder to pump blood through the affected area. Spasms are usually brief but can last for more than 15 minutes in some cases.

It can be hard for a medical professional to diagnose coronary artery spasms. A person with coronary artery spasms may present no symptoms. As a result, it is hard to determine the prevalence of the condition in the general population, according to reviews,

Symptoms can vary between people and often between occurrences. Symptoms can be so mild that a person may not realize they are experiencing a spasm at all or so severe that they are physically disabling.

Coronary artery spasms differ from traditional chest pains primarily due to their occurrence when a person is at rest rather than as a result of exertion. In fact, research has found that a person is most likely to experience symptoms of coronary artery spasms between midnight and early morning.

What does it feel like?

When symptoms do occur, they can include:

  • chest pain, which may be severe
  • pain that may radiate to the head or shoulders
  • a burning feeling in the chest
  • a sense of tightness in the chest
  • a pressure or squeezing sensation
  • sweating
  • feeling nauseated or faint

Severity

In severe cases, a person may experience intense, prolonged, chest pains accompanied by cold sweat, nausea, or vomiting, and sometimes a temporary loss of consciousness. A person suffering a coronary artery spasm may also feel muscular pain in their arm or jaw.

Alternatively, a person may experience mild versions of these symptoms, or none at all. According to one review, a person is twice as likely to experience coronary artery spasms without any visible symptoms than with symptoms.

The causes of coronary artery spasms are complex and multi-faceted. The body’s automatic nervous system, a person’s levels of chronic inflammation, and any underlying heart conditions may all play a part in causing coronary artery spasms, according to a 2020 review.

In addition, many other bodily mechanisms may be involved, depending on a person’s unique physical state.

Research into coronary artery spasms has identified many risk factors.

One of the most common factors is smoking. Other potential causes or triggers of a coronary artery spasm include:

Stress and other mental health factors may affect a person’s risk of coronary artery spasms. However, research on this topic is inconclusive and requires further study. The condition reportedly afflicts females more often than males.

There are three main ways to diagnose coronary artery spasm:

  • Coronary angiography: This is an X-ray-like test that creates images of blood vessels
  • Electrocardiogram: A test that checks for abnormal electrical patterns in the heart
  • Echocardiogram: This technique uses ultrasound technology to examine heart valves and blood flow

These tests may reveal symptoms of coronary artery spasms. However, the only way for a medical professional to diagnose the condition definitively is by doing an additional test called provocative testing.

During provocative testing, doctors use specific drugs to cause or “provoke” a spasm, which allows them to diagnose the condition with certainty.

There is no singular cure for coronary artery spasm, but there are several ways to manage the condition and reduce symptoms.

Quitting smoking is the most helpful lifestyle change. A person may also reduce their risk of repeat spasms through changes to their activity levels and diet.

A doctor may also prescribe certain medications, including:

  • calcium channel blockers to reduce muscle tightening in the chest
  • nitrates to ease chest pain
  • statins to lower cholesterol and strengthen arteries

When medications and lifestyle changes do not work, doctors may recommend more invasive procedures to remedy the issue. Bypass surgery is a last resort.

Smoking is a well-documented risk factor for coronary artery spasms. A person may help prevent the development of symptoms by reducing their smoking or quitting altogether.

Consumption of alcohol and some illegal drugs may also trigger coronary artery spasms. Therefore, reducing or eliminating the intake of these agents may also assist in prevention.

Coronary artery spasms are normally experienced at rest, unlike many other heart complications. Due to this, a person usually does not have to stop physical activity as a preventative measure. In fact, a 2016 review of vasospastic angina reported that aerobic exercise can lead to a reduction in blood-flow related heart conditions.

Once a doctor diagnoses a person with this condition, the doctor may recommend medication such as calcium channel blockers, nitrates, and statins to prevent further symptoms.

If left untreated, coronary artery spasms may occur more frequently and can lead to further complications such as heart attacks and sudden death.

The likelihood of complications may also increase if a person has other underlying heart conditions, such as coronary heart disease.

Coronary artery spasms can also cause different forms of arrhythmia, which is a change in the way the heart beats.

Learn more about arrhythmia here.

According to medical reviews, the long-term outlook for patients who experience coronary artery spasms without other underlying heart conditions is good.

Medication can help patients control spasms and their symptoms over time. A person should continue with prescribed medications or treatments even if they no longer experience symptoms of coronary artery spasms.

Lifestyle changes may also improve a person’s outlook. Avoiding smoking is a critical factor in reducing episodes of coronary artery spasms.