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What is a coronary spasm?

Coronary spasm is a sudden 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 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
• nausea
• sweating
• light-headedness
• difficulty breathing.
• palpitations (a sense of a rapid or irregular heartbeat) or other abnormal heart rhythms.

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 health care 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 (a special x-ray where a dye highlights 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 provider will develop a treatment plan that includes:

• learning about coronary spasm and gaining reassurance that it is a treatable condition
• taking medication to help prevent coronary artery spasm
• reviewing your lifestyle and habits to reduce your risk factors for heart disease
• having frequent follow-up appointments to check your progress.
• stopping the use of drugs that cause coronary spasm

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 medication.

How can I take care of myself?

To help take care of yourself:

• Follow your health care provider's recommendations.
• Take your medication as directed.
• Report new or changing symptoms at once.
• Follow your provider's advice for reaching or maintaining your ideal weight, blood pressure, blood sugar, and cholesterol levels and for getting enough exercise.
• 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:

• quitting smoking
• exercising regularly according to your health care provider's advice
• avoiding drugs that cause spasms
• limiting caffeine and other stimulants
• reaching and maintaining your ideal weight
• eating foods that are low in cholesterol, low in fat, and high in complex carbohydrates and fiber.