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Coronary artery spasm - Overview

Alternative Names

Variant angina; Angina - variant; Prinzmetal's angina; Vasospastic angina

Definition of Coronary artery spasm:

Coronary artery spasm is a temporary, sudden narrowing of one of the coronary arteries (the arteries that supply blood to the heart). The spasm slows or stops blood flow through the artery and starves part of the heart of oxygen-rich blood.

Causes, incidence, and risk factors:

The spasm often occurs in coronary arteries that have not become hardened due to plaque buildup (atherosclerosis). However, it also can occur in arteries with plaque buildup.

The spasm often occurs in coronary arteries that have not become hardened due to plaque buildup (atherosclerosis). However, it also can occur in arteries with plaque buildup. These spasms are due to a squeezing of muscles of the artery' s wall. They occur in just one area of the artery. The coronary artery may appear normal during testing, but it does not function normally.

About 2% of patients with angina have coronary artery spasm.

Coronary artery spasm occurs most commonly in people who smoke or who have high cholesterol or high blood pressure. It may occur without cause, or it may be triggered by:

  • Alcohol withdrawal
  • Emotional stress
  • Exposure to cold
  • Medications that cause narrowing of the blood vessels (vasoconstriction)
  • Stimulant drugs such as amphetamines and cocaine

Cocaine use and cigarette smoking can cause severe spasm of the arteries, and can cause the heart to work harder. In many people, coronary artery spasm may occur without any other heart risk factors (such as smoking, diabetes, high blood pressure, and high cholesterol).

  • Reviewed last on: 6/28/2011
  • David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington.

References

Cannon CP, Braunwald E. Unstable angina and non-ST elevation myocardial infarction. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, PA: Saunders; 2007:chap 53.

Stern S, Bayes de Luna A. Coronary artery spasm: a 2009 update. Circulation. 2009 May 12;119(18):2531-4.

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