Coronary artery spasm: A cause of heart attacks?

Can a coronary artery spasm cause a heart attack?

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Mayo Clinic cardiologist Martha Grogan, M.D., and colleagues answer select questions from readers.

Answer

Yes. A coronary artery spasm is a brief, temporary tightening (contraction) of the muscles in the artery's walls. This can narrow and even briefly close the coronary arteries, reducing or interrupting blood flow to part of the heart muscle (myocardium). If the spasm lasts long enough, it can lead to chest pain (angina) and possibly a heart attack (myocardial infarction). Doctors often refer to such spasms as Prinzmetal's angina or variant angina. Unlike typical angina, which usually occurs with exertion, Prinzmetal's angina often occurs at rest.

Coronary artery spasms occur most often in people with risk factors for heart disease, such as tobacco use, high cholesterol and high blood pressure. They may also be associated with other diseases, such as lupus. Coronary artery spasms may be triggered by tobacco use, exposure to cold, extreme emotional stress and use of illicit stimulant drugs, such as amphetamines and cocaine.

Treatment of coronary artery spasms may include medications such as nitrates, calcium channel blockers and 1-arginine, which may reduce the risk of recurrence. You can also reduce your risk by discontinuing tobacco use and controlling high cholesterol and high blood pressure.