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Coronary vasospasm is smooth muscle contraction in the blood vessels that supply oxygenated blood to the heart. When these vessels contract, the heart doesn’t get enough oxygen, and the patient may experience chest pain and discomfort. This condition can put patients at risk of serious cardiac disorders, including myocardial infarction, where parts of the muscle are temporarily deprived of oxygen and they are damaged or start to die. Treatments can include medication and surgery in some cases, although pharmaceutical management tends to be more successful.
In patients with coronary vasospasm, the coronary circulation that supplies fresh blood to the heart experiences spasms. These may be associated with exercise or other activities, or can be random in nature. Patients may report spikes of pain and discomfort, and in some cases think they are having heart attacks because of the chest pain. Medical evaluation for cases of suspected coronary vasospasm can include an electrocardiograph test along with imaging of the heart to assess circulation and blood flow.
Some of the problems associated with coronary vasospasm include: a form of angina called Prinzmetal’s angina; cardiac arrhythmias; and myocardial infarctions. Patients tend to be older when they develop coronary vasospasm and they may have a history of circulatory problems. Women, particularly those of Asian descent, are more at risk than men. This condition can be serious and it is important to receive treatment for it.
Medical emergencies may require the use of nitrates to encourage the vessels to relax and allow the patient to get enough blood. Long-term management of coronary vasospasm may involve a mixture of nitrates and beta blockers that keep the smooth muscle relaxed. Patients with separate cardiovascular problems like blockages in the coronary arteries may need surgery to treat those, but surgical treatments for standalone cases of coronary vasospasm are usually not successful.
People who start to develop chest pain should get a medical evaluation, as it can be a sign of an underlying problem. It helps to take note of when the pain appears and to rank it by severity. Intense pain with radiating numbness and tingling, loss of balance, or confusion is a cause for immediate medical treatment. A cardiologist can evaluate the patient, provide appropriate short-term care, and determine how to proceed with managing the problem in the future to reduce incidents and protect the patient’s health. Coronary vasospasm can become a life-long problem but it may be controllable with medication and some lifestyle changes.