What Is a Coronary Artery Spasm?

silent heart attackOf course you know what a heart attack is, but there’s another heart related event that you may be less familiar with - a condition called coronary arterial spasm. A person experiencing a coronary artery spasm can have many of the same symptoms as a person having a heart attack – including chest pain, lightheadedness, and even fainting, and, in some cases, it can be difficult to distinguish a coronary artery spasm from a heart attack.

What Exactly is a Coronary Artery Spasm?

The coronary arteries are the arteries that supply blood to the heart. Since the coronary arteries are the main blood supply to the heart, it’s easy to see how important their function is. A conventional heart attack occurs when a clot develops in one of these arteries - often brought on by build-up of plaque and calcium which cause reduced blood flow to the heart. Without oxygenated blood, the heart muscle pumps less effectively and can go into an abnormal rhythm.

A coronary artery spasm is where one of the coronary artery goes into a sustained contraction that reduces blood flow to the heart causing the heart muscle to weaken. A coronary arterial spasm differs from a heart attack in that a blood clot doesn’t occur and the contraction that leads to the spasm is temporary. Coronary artery spasm is often – but not always – seen in coronary arteries that already have some plaque build-up or disease.

What Causes a Coronary Artery Spasm?

The cause of coronary arterial spasm isn’t completely understood, but it’s thought that elevated levels of stress hormones and build-up of fatty material in the coronary arteries plays a role. It’s sometimes triggered by stress, exposure to temperature extremes, alcohol intoxication, and certain medications – particularly stimulants. It’s more commonly seen in people who have other risk factors for heart disease such as elevated cholesterol, high blood pressure, and people who smoke.  

What are the Symptoms of Coronary Arterial Spasm?

The symptoms of coronary spasm can be very similar to those of a heart attack. The classic symptom is chest pain which can last up to thirty minutes and may be associated with fainting or loss of consciousness. Unlike angina-type chest pain which is usually brought on by exertion, coronary artery spasm may come on when a person is quietly resting. The problem that, in rare cases, the spasm can last so long that it leads to heart damage and a true heart attack. In other cases, a coronary artery spasm can cause an irregular heart rhythm. So, even though they’re not a true heart attack, they can cause problems of their own and even lead to sudden death.  

How is Coronary Arterial Spasm Diagnosed and Treated?

After the diagnosis is made with the help of an electrocardiogram and cardiac angiography, a person who suffers from coronary artery spasms is usually placed on medications to reduce resistance in the coronary arteries as well as the risk of spasm. Most commonly calcium channel blockers are used. Nitroglycerin is often given when episodes of chest pain occur. It’s important that smoking be discontinued and obesity and elevated cholesterol levels be treated in people with coronary artery spasms to reduce the risk of spasm as well as the risk of more serious heart problems.

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