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    Martha Grogan, M.D.

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Question

Coronary artery spasm: Cause for concern?

What is a coronary artery spasm?

Answer

from Martha Grogan, M.D.

A coronary artery spasm is a brief, temporary tightening (contraction) of the muscles in an artery wall in your heart. This can narrow and decrease or even prevent blood flow to part of the heart muscle.

If the spasm lasts long enough, it can lead to chest pain (angina) and possibly a heart attack (myocardial infarction). These spasms may also be referred to as Prinzmetal's angina or variant angina. Unlike typical angina, which usually occurs with physical activity, coronary artery spasms often occur at rest.

Coronary artery spasms are more common in people with risk factors for heart disease, such as high cholesterol and high blood pressure, but the spasms can happen in people who have no risk factors, too. Coronary artery spasms can also occur in people who have conditions that affect their immune systems, such as lupus.

Coronary artery spasms may be triggered by:

  • Tobacco use
  • Exposure to cold
  • Extreme emotional stress
  • Use of illegal stimulant drugs, such as amphetamines and cocaine

Treatment of coronary artery spasms may include medications such as:

  • Nitrates, which can relieve chest pain
  • Calcium channel blockers, which can help reduce muscle tightening in your chest
  • L-arginine, a supplement that can help prevent spasms
  • Statin medications, which not only lower cholesterol but have other beneficial effects on your heart arteries to prevent spasms

You can reduce your risk of coronary artery spasms by quitting smoking and controlling high cholesterol and high blood pressure.

Next question
Coronary artery disease: Angioplasty or bypass surgery?
References
  1. Coronary artery spasm. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=4520. Accessed April 12, 2010.
  2. Waller BF. Nonatherosclerotic coronary heart disease. In: Furster V, et al. Hurst's The Heart. 12th ed. Columbus, Ohio: McGraw-Hill Companies; 2008. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=5. Accessed April 12, 2010.
  3. Coronary artery spasm. University of Maryland Medical Center. http://www.umm.edu/ency/article/000159.htm. Accessed April 12, 2010.
AN01371 June 18, 2010

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