Coronary Artery Spasm

What is a coronary artery spasm?

A coronary artery spasm is a tightening (contraction) of your heart’s arteries (coronary arteries). These spasms don’t usually last long, and you may not even notice them. But they can increase your risk of heart attack and other heart complications.

What are coronary arteries?

Your coronary arteries are blood vessels that supply blood to your heart muscle. When these arteries tighten, they temporarily decrease or block blood flow to your heart muscle.

What is the difference between a coronary artery spasm and angina?

Coronary artery spasms may lead to chest pain known as angina. While artery blockage from cholesterol plaque is a more common cause of angina, coronary spasms can also result in chest pain called vasospastic angina. Unlike angina from plaque, vasospastic angina can often happen while you are resting.

Who might get a coronary artery spasm?

If you have risk factors for heart disease, you also have risk factors for a coronary artery spasm. The most common risk factors include:

• High blood pressure (hypertension).
• High cholesterol (hyperlipidemia).
• Smoking or using tobacco products.
• Recreational drug use.

Many people who don’t have high blood pressure or high cholesterol experience coronary artery spasms. Often, these people smoke regularly.

What causes a coronary artery spasm?

Certain heart conditions can cause a coronary artery spasm, including:

• Atherosclerosis, when your arteries build up with plaque and become narrow.
• High blood pressure.
• High cholesterol.

Often, something triggers a coronary artery spasm, such as:

• Tobacco use.
• Exposure to cold temperatures.
• Extreme stress.
• Use of stimulants, such as amphetamines or cocaine.

What are the symptoms of a coronary artery spasm?

You may not have any noticeable symptoms of a coronary artery spasm. If you do, you might feel light chest pain, especially pain that occurs:

• During rest, often after midnight or in early morning hours.
• On the left side of your chest.

A coronary artery spasm may wake you up at night. You may have spasms as infrequently as a few times a year or as often as a few times a day.

How long does a coronary artery spasm last?

Coronary artery spasms vary in length. They may last anywhere from five to 30 minutes.

What does a coronary artery spasm feel like?

Sometimes, you don’t feel a coronary artery spasm at all. Or you may feel:

• Chest tightness.
• Pain extending from your chest to your neck, arms or jaw.

How is a coronary artery spasm diagnosed?

To diagnose a coronary artery spasm, your healthcare provider uses tests that check your heart health, including:

• Echocardiogram (echo test) uses sound waves to take pictures of your heart.
• Electrocardiogram (EKG) measures your heart’s electrical signals.
• Coronary angiography uses a special dye and imaging scans to watch how blood flows through your heart arteries.

Your provider may also give you an ambulatory monitor to wear at home. This monitor records your heart’s electrical activity as you do your daily activities. It gives your provider a better view of your heartbeat throughout the day. The monitor also records heart activity at night, which can be important for diagnosing coronary artery spasms.

How is a coronary artery spasm treated?

The goal of treatment is to prevent spasms and relieve chest pain. If you have a spasm, a medicine called nitroglycerin (Nitrostat®) widens your arteries to improve blood flow and relieve chest pain.

To prevent spasms long term, your provider may prescribe medications:

• Calcium channel blockers, such as amlodipine (Norvasc®), diltiazem (Cardizem®) or nifedipine (Procardia®), relax your arteries.
• Statins, such as atorvastatin (Lipitor®) or simvastatin (Zocor®), lower your cholesterol and may prevent spasms.

Sometimes, coronary artery spasms lead to an irregular heart rhythm in your heart’s lower chambers (ventricular arrhythmia). If you have ventricular arrhythmia, your provider may recommend an implantable cardioverter defibrillator (ICD) to prevent any serious complications. ICDs use electrical signals to keep your heartbeat in a regular rhythm.

How can I reduce my risk of coronary artery spasms?

If you have high cholesterol or other risk factors, treating these conditions can reduce your risk of spasms. You can also avoid triggers, such as extreme cold or smoking cigarettes, that can lead to coronary artery spasms.

What can I expect if I have coronary artery spasms?

Coronary artery spasms are chronic, meaning you need long-term treatment to manage them. With treatment, most people control symptoms and experience fewer spasms.

When should I go to the ER?

Coronary artery spasms that last a long time may lead to a heart attack. Call 911 immediately if you have any signs of a heart attack, including chest pain along with:

• Dizziness or lightheadedness.
• Fainting (syncope).
• Heart racing (palpitations).
• Nausea or indigestion (dyspepsia).
• Shortness of breath (dyspnea).
• Sweating.

A note from Cleveland Clinic

A coronary artery spasm is a sudden tightening of the arteries that send blood to your heart. The spasms are quick and may be painless, but they can increase your risk of a heart attack. Coronary artery spasms often happen in late-night or early-morning hours and may wake you up. Treatment focuses on relieving chest pain and preventing spasms.