Overview, Causes, & Risk Factors
The coronary arteries are a pair of blood vessels that carry oxygen-rich blood to the heart muscles. A spasm in these arteries known as a vasospasm reduces blood flow to the heart. This causes a chest pain called angina.
What is going on in the body?
Most often, vasospastic angina occurs while a person is at rest or it wakes a person from sleep. Typical angina is linked with physical activity and caused by fat deposits clogging the arteries, or atherosclerosis. Vasospastic angina differs in that it can happen whether a person:
is active or resting
does or does not have clogged arteries from atherosclerosis
When the spasms occur, blood flow to the heart lessens. This causes the pain and raises the risk of a heart attack.
What are the causes and risks of the condition?
The coronary arteries and other blood vessels may constrict due to:
certain medications, such as vasopressin or ergonovine
cocaine
exposure to cold
high levels of stress
Sometimes, strenuous activity can bring on an attack.
Symptoms & Signs
What are the signs and symptoms of the condition?
Symptoms of vasospastic angina are similar to those of typical angina:
chest pain
shortness of breath
rapid heartbeats called palpitations
These symptoms occur:
at rest
during sleep
with or without physical exertion
Diagnosis & Tests
How is the condition diagnosed?
A healthcare provider may suspect coronary artery spasms based on a person's symptoms. A pattern of chest pain at rest, for example, is suspicious, especially if a person has no history of blocked coronary arteries or heart attack. However, some people with this disease also have blocked coronary arteries.
An electrocardiogram, or ECG may be normal between attacks. During attacks, the ECG may record changes that show a lack of blood flow to the heart. A procedure called a cardiac catheterization can find clogged blood vessels.
Often, vasospastic angina can be diagnosed only after other possibilities have been excluded.
Prevention & Expectations
What can be done to prevent the condition?
Generally, nothing can be done to prevent the condition.
What are the long-term effects of the condition?
A person with coronary artery spasms has a higher risk of:
irregular heart rhythms, or arrhythmias
heart attack
sudden death
What are the risks to others?
There are no risks to others.
Treatment & Monitoring
What are the treatments for the condition?
If a person has severely blocked coronary arteries, surgery may stop the vasospasms. Those who have fewer symptoms and no coronary artery blockages respond well to heart medication.
A person should also:
eat a healthy diet, following the Food Guide Pyramid
exercise regularly
quit smoking
use alcohol in moderation
What are the side effects of the treatments?
All medications have side effects. Medications used to treat coronary artery spasm may cause
headache
fatigue
sleep disorders such as insomnia
dizziness
serious arrhythmias
What happens after treatment for the condition?
Uncomplicated cases are usually well controlled with heart medication.
How is the condition monitored?
Monitoring includes:
blood tests
ECG tests
stress tests, or an ECG of the heart's function during exercise
A person should report any change in the pattern or severity of chest pains to his or her healthcare provider right away.
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