Coronary Spasm

What is a coronary spasm?

Coronary spasm is a sudden and temporary narrowing or tightening of a small part of a coronary artery (an artery that supplies blood to the heart). As a result, your heart temporarily does not get enough oxygen and you feel a type of chest pain called angina.

This type of chest pain may also be called Prinzmetal's angina, atypical angina, or variant angina.

How does it occur?

It is not known why these spasms occur. In young people, coronary spasms are most often related to the use of drugs, especially cocaine.

What are the symptoms?

Symptoms of coronary spasm include:

• chest pain that feels like a strangling or heavy pressure on the chest
• pain that starts in the chest and spreads to the throat, arms (usually the left arm), and jaws, and between the shoulder blades; the pain can also spread to the stomach and feel like an ulcer or indigestion
• a feeling of tightness or heaviness in the chest
• nausea
• sweating
• lightheadedness
• trouble breathing
• palpitations (rapid or irregular heartbeats), skipped beats, or a "flip-flop" feeling in your chest.

How is it diagnosed?

If your health care provider suspects you are having coronary spasms, he or she will examine you and order an ECG (electrocardiogram). An ECG records your heart rhythms. The recording may show certain changes when you have pain caused by a coronary spasm. Your provider may have you wear a small, portable ECG recorder called a Holter monitor. It can record your heart rhythms for 24 to 72 hours.

You may also need a stress or treadmill ECG. During this type of ECG, the activity of your heart is recorded while you exercise on a stationary bike or treadmill.

You may need a coronary angiogram, which is a special x-ray using a dye to give pictures of the arteries. It can show blockages in your arteries. Sometimes it can show areas of spasm. During the test, medicine may be injected into your arteries to start a spasm.

How is it treated?

The goal of treatment is to prevent or control symptoms. You and your health care provider will develop a treatment plan that includes:

• stopping the use of drugs that cause coronary spasm
• taking medicine to help prevent spasm
• reviewing your lifestyle and habits to reduce your risk for heart disease
• having frequent follow-up appointments to check your progress.

How long will the effects last?

The effects will last as long as the cause of the spasm exists or until the spasm responds to medicine.

How can I take care of myself?

To help take care of yourself:

• Avoid using drugs that cause spasms.
• Take your medicine as directed by your health care provider.
• Report new or changing symptoms right away.
• Learn how anxiety and stress affect you. Learn methods to help you cope with stress.

To help prevent problems with coronary spasms, reduce your risk for heart disease as much as possible by also:

• not smoking
• exercising regularly according to your health care provider's advice
• limiting caffeine and other stimulants
• reaching and maintaining a healthy weight
• eating foods that are low in cholesterol, low in fat, and high in complex carbohydrates and fiber.