There is a link between coronary artery spasms and anxiety. Psychological factors, such as anxiety and depression, may cause physical changes to the arteries that supply blood to the heart.

Around 40% of people undergoing an elective coronary angiogram have no obstructive disease to explain their symptoms.

Instead of coronary artery disease, their symptoms may result from temporary spasms in the arteries on the surface of the heart. In some cases, this occurs from a psychological trigger, such as stress or anxiety.

This article will discuss the connection between coronary artery spasms and anxiety. It also examines the symptoms, treatment, and outlook for them.

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Coronary arteries are blood vessels on the surface of the heart. A coronary artery spasm is a sudden temporary narrowing of the vessels that supply the heart with blood.

A spasm is an involuntary and uncontrolled muscle contraction. When spasm occurs in these vessels, they become narrow, reducing the heart’s blood supply.

A 2019 study found that, in comparison with the general population or those with coronary artery disease, people with diagnoses of anxiety or depression had a higher risk of developing coronary artery spasms. Psychological stress can also trigger a coronary artery spasm.

Researchers theorize that certain types of nervous system activation can cause changes such as:

These changes increase hyperactivity in the smooth muscle that lines the blood vessels, which can lead to coronary artery spasms.

The link between anxiety and coronary artery spasms may also involve substance use. Substance use can occur with mental health conditions such as anxiety and depression.

Recreational substances that may contribute to arterial spasms include:

  • tobacco
  • alcohol
  • cocaine
  • cannabis
  • amphetamines

Symptoms of coronary artery spasms include angina, which refers to chest pain and discomfort that occurs when blood flow to the heart is restricted.

The pain may:

  • not have associations with physical activity
  • not have links to heart rate changes
  • develop during sleep or early in the morning

The symptoms may occur several hours after alcohol use.

First, a person’s doctor should rule out other possible cardiac issues that may need treatment.

If symptoms are due to coronary artery spasms, addressing triggers, such as cigarette smoking, drug use, or anxiety, may reduce the frequency of chest pains.


A 2015 review examined the link between psychological interventions for nonspecific chest pain.

The review found a modest to moderate benefit from treatments, such as psychotherapy and hypnotherapy, for treating chest pain involving typical anatomy.


Coronary artery spasms and anxiety are both conditions that respond to medication.

First-line treatment for coronary artery spasms includes:

  • Nitrates: This medication widens blood vessels by relaxing the muscle in the vessel walls.
  • Calcium channel blockers: This medication reduces the amount of calcium that can enter the vascular muscle. Calcium helps muscles contract.

Common anxiety medications include:


A person’s lifestyle may affect how much anxiety-related chest pain they experience.

Protective measures include:

  • a regular sleep schedule
  • effective sleep hygiene
  • a nutrient-dense diet
  • regular physical activity
  • nurturing social connections
  • stress reduction strategies
  • smoking cessation, if applicable
  • reduction or elimination of alcohol use, if applicable

There are strategies that may reduce anxiety. These can include:

  • Deep breathing: This can ease pain by slowing respiration and relaxing the chest muscles.
  • Mantras: This is a word, phrase, or sound a person utters while meditating. Mantras can be calming and distract a person from their anxiety and pain.
  • Mindfulness: This is the practice of being aware of the present moment and can help ground someone to reduce anxiety.

Therapy is effective for many people living with anxiety.

Options, such as cognitive behavioral therapy, can teach a person how to reframe their thoughts. This helps them see their triggers in new ways that are less likely to provoke their anxiety.

Medications work on chemicals in the brain to reduce anxiety symptoms. Some people find it effective to combine medication with therapy.

Self-care strategies include lifestyle interventions, such as improving diet, getting more sleep, and building supportive social connections.

If a person experiences new chest discomfort, they need to seek immediate medical attention. They should never assume it is due to anxiety.

They also need to contact a doctor if they are finding it challenging to tackle their feelings of anxiety or if anxiety is affecting their daily lives.

Prolonged coronary artery spasm can lead to a heart attack. This is when a lack of blood flow to the heart can damage part of the heart muscle.

A heart attack is a medical emergency and requires prompt treatment.

Symptoms include:

  • sudden and persistent chest pain, pressure, squeezing, or heaviness
  • pain that radiates to the arms, jaw, neck, stomach, or back
  • nausea
  • perspiration
  • shortness of breath
  • light-headedness
  • panic attack
  • excessive wheezing or coughing

A person with these symptoms needs to seek medical attention as soon as possible.

Coronary artery spasms can lead to serious complications, including heart attack, arrhythmia, and sudden cardiac death.

However, in general, the outlook of coronary artery spasms is positive, particularly in those who can tolerate medications and cease smoking if they previously smoked.

Anxiety and coronary artery spasm can occur together in some people.

Experts suggest this is because psychological triggers can increase the smooth muscle hyperactivity in the blood vessel walls, causing them to contract.

Since coronary artery spasms can sometimes lead to a heart attack. A person experiencing heart attack symptoms needs to seek immediate medical care.

The outlook can be favorable if a person follows their doctor’s treatment plan and manages their anxiety.