BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuCoronary artery spasmVariant angina; Angina - variant; Prinzmetal angina; Vasospastic angina; Chest pain - PrinzmetalThe coronary arteries supply blood and oxygen to the heart. Coronary artery spasm is a brief, sudden narrowing of one of these arteries.Previous imagePlay SlideshowStop SlideshowNext image / Causes The spasm often occurs in coronary arteries that have not become hardened due to plaque buildup. However, it also can occur in arteries with plaque buildup.These spasms are due to a squeezing of muscles in the artery wall. They most often occur in just one area of the artery. The coronary artery may appear normal during testing, but it does not function normally at other times.About 2% of people with angina (chest pain and pressure) have coronary artery spasm.AnginaAngina is a type of chest discomfort or pain due to poor blood flow through the blood vessels (coronary vessels) of the heart muscle (myocardium). T...Read Article Now Book Mark Article Previous imagePlay SlideshowStop SlideshowNext image / 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:High cholesterolCholesterol is a fat (also called a lipid) that your body needs to work properly. Too much bad cholesterol in your blood can increase your chance of...ImageRead Article Now Book Mark Article High blood pressureBlood pressure is a measurement of the force exerted against the walls of your arteries as your heart pumps blood to your body. Hypertension is the ...ImageRead Article Now Book Mark Article Alcohol withdrawal Emotional stress StressStress is a feeling of emotional or physical tension. It can come from any event or thought that makes you feel frustrated, angry, or nervous. Stres...ImageRead Article Now Book Mark Article Exposure to cold Medicines that cause narrowing of the blood vessels (vasoconstriction) Stimulant drugs, such as amphetamines and cocaineCocaine use and cigarette smoking can cause severe spasms of the arteries. This causes 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). Symptoms Spasm may be "silent" (without symptoms) or it may result in chest pain or angina. If the spasm lasts long enough, it may even cause a heart attack.Related video goes here for no-HTML5 browsersThe main symptom is a type of chest pain called angina. Typically, the chest pain feels like tightness, heavy pressure, squeezing, or a crushing feeling. It may spread to the:Arm (most often the left) Back Jaw Neck ShoulderSome people say the pain feels like gas or indigestion. It is most often severe. The pain may spread to the neck, jaw, shoulder, or arm.The pain of coronary artery spasm:Often occurs at rest May occur at the same time each day, usually between midnight and 8:00 a.m. Lasts from 5 to 30 minutesThe person may lose consciousness.Chest pain and shortness of breath due to coronary artery spasm are often not caused by exercise, unlike angina that is caused by hardening of the coronary arteries. Exams and Tests Tests to diagnose coronary artery spasm may include:Coronary angiography Coronary angiographyCoronary angiography is a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through the arteries in your heart....ImageRead Article Now Book Mark Article Electrocardiogram (ECG) ElectrocardiogramAn electrocardiogram (ECG) is a test that records the electrical activity of the heart.ImageRead Article Now Book Mark Article Echocardiography Treatment The goal of treatment is to control chest pain and prevent a heart attack. A medicine called nitroglycerin (NTG) can relieve an episode of pain.Your health care provider may prescribe other medicines to prevent chest pain. You may need long term treatment with a type of medicine called a calcium channel blocker or a long-acting nitrate.Beta-blockers are another type of medicine that is used with other coronary artery problems. However, beta-blockers may make coronary artery spasm worse. They should be used with care.If you have this condition, you should avoid coronary artery spasm triggers. These include exposure to cold, cocaine or amphetamine use, cigarette smoking, and high-stress situations. Outlook (Prognosis) Coronary artery spasm is a long-term (chronic) condition. However, treatment most often helps control symptoms.ChronicChronic refers to something that continues over an extended period of time. A chronic condition is usually long-lasting and does not easily or quick...ImageRead Article Now Book Mark Article The disorder may be a sign that you have a high risk for heart attack or deadly irregular heart rhythms. The outlook is most often good if you follow your treatment, your provider's advice, and avoid certain triggers. Possible Complications Complications may include:Abnormal heart rhythms, which may cause cardiac arrest and sudden death Heart attacks When to Contact a Medical Professional Immediately call the local emergency number (such as 911) or go to the hospital emergency room if you have a history of angina and the crushing or squeezing chest pain is not relieved by nitroglycerin. The pain may be due to a heart attack. Rest and nitroglycerin often do not completely relieve the pain of a heart attack.A heart attack is a medical emergency. If you have symptoms of a heart attack, seek medical help right away.Heart attackMost heart attacks are caused by a blood clot that blocks one of the coronary arteries. The coronary arteries bring blood and oxygen to the heart. ...ImageRead Article Now Book Mark Article Prevention Take steps to reduce your risk of developing heart disease. Some studies have shown that making a few lifestyle changes can reduce your risk for heart disease. Lifestyle changes can also help prevent some angina attacks. Your provider may tell you to:Lose weight if you are overweight Stop smoking Exercise regularly Drink alcohol in moderation only Eat a healthy diet that is high in vegetables, fruits, whole grains, fish, and lean meatsYour provider will also recommend that you keep other health conditions such as high blood pressure, diabetes, and high cholesterol levels under control.Previous imagePlay SlideshowStop SlideshowNext image / Open ReferencesReferencesAmsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. Circulation. 2014;130(25):2354-2394. PMID: 25249586 pubmed.ncbi.nlm.nih.gov/25249586/.Boden WE. Angina pectoris and stable ischemic heart disease. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 56.Giugliano RP, Braunwald E. Non-ST Elevation Acute Coronary Syndromes. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 39.Ibanez B, James S, Agewall S, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the Management of Acute Myocardial Infarction in Patients Presenting with ST-segment Elevation of the European Society of Cardiology (ESC). Eur Heart J. 2018;39(2):119-177. PMID: 28886621 pubmed.ncbi.nlm.nih.gov/28886621/.Lange RA, Mukherjee D. Acute coronary syndrome: unstable angina and non-ST elevation myocardial infarction. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 57.Writing Committee Members, Gulati M, Levy PD, Mukherjee D, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the evaluation and diagnosis of chest pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2021;78(22):e187-e285. PMID: 34756653 pubmed.ncbi.nlm.nih.gov/34756653/.AllVideoImagesTogAngina causes and symptomsAnimation Related video goes here for no-HTML5 browsersAngina causes and symptoms - Animation Angina, or angina pectoris, is temporary chest pain or a sensation of pressure that occurs when the heart’s need for oxygen is not satisfied by the amount of blood supplied to the heart. Blood flow can be limited when the arteries are narrowed by atherosclerosis, or because of coronary artery spasms. Symptoms of angina may also include discomfort in the shoulders, inside the arms, through the back and in the throat, jaw, or teeth. Angina due to atherosclerosis usually occurs during physical exertion or emotional distress, or at rest if the artery is narrowed by more than 70%.Angina - illustration Angina is a specific type of pain in the chest caused by inadequate blood flow through the blood vessels (coronary vessels) of the heart muscle (myocardium).AnginaillustrationCoronary artery spasm - illustration Coronary artery spasm is a temporary constriction of an artery in the heart. The spasm can slow or stop blood flow through the artery. The main symptom experienced is chest pain.Coronary artery spasmillustrationArtery cut section - illustration The structure of blood vessel walls is important in the regulation of blood flow. The tunica media contains smooth muscle fibers which contract to either dilate or constrict the size of the vessel. These small changes in the vessel lumen can greatly influence blood pressure and blood flow. Therefore, the tunica media plays an important role in maintaining blood pressure and continuous blood circulation.Artery cut sectionillustrationPrevention of heart disease - illustration Heart disease may be prevented by recommended healthy diet, regular exercise and to stop smoking if you are a smoker. Follow your health care provider's recommendations for treatment and prevention of heart disease.Prevention of heart diseaseillustrationAngina causes and symptomsAnimation Related video goes here for no-HTML5 browsersAngina causes and symptoms - Animation Angina, or angina pectoris, is temporary chest pain or a sensation of pressure that occurs when the heart’s need for oxygen is not satisfied by the amount of blood supplied to the heart. Blood flow can be limited when the arteries are narrowed by atherosclerosis, or because of coronary artery spasms. Symptoms of angina may also include discomfort in the shoulders, inside the arms, through the back and in the throat, jaw, or teeth. Angina due to atherosclerosis usually occurs during physical exertion or emotional distress, or at rest if the artery is narrowed by more than 70%.Angina - illustration Angina is a specific type of pain in the chest caused by inadequate blood flow through the blood vessels (coronary vessels) of the heart muscle (myocardium).AnginaillustrationCoronary artery spasm - illustration Coronary artery spasm is a temporary constriction of an artery in the heart. The spasm can slow or stop blood flow through the artery. The main symptom experienced is chest pain.Coronary artery spasmillustrationArtery cut section - illustration The structure of blood vessel walls is important in the regulation of blood flow. The tunica media contains smooth muscle fibers which contract to either dilate or constrict the size of the vessel. These small changes in the vessel lumen can greatly influence blood pressure and blood flow. Therefore, the tunica media plays an important role in maintaining blood pressure and continuous blood circulation.Artery cut sectionillustrationPrevention of heart disease - illustration Heart disease may be prevented by recommended healthy diet, regular exercise and to stop smoking if you are a smoker. Follow your health care provider's recommendations for treatment and prevention of heart disease.Prevention of heart diseaseillustrationRelated Information Stable angina(Condition)Unstable angina(Condition)Heart attack(Condition)Stress and your health(Symptoms)Angina(Condition)Angina - what to ask your doctor (Doctor Questions)Angina - when you have chest pain(Self-Care)Angina - discharge(Discharge)Coronary artery disease - InDepth(In-Depth)Heart attack and acute coronary syndrome - InDepth(In-Depth)Anxiety disorders - InDepth(In-Depth) Review Date: 1/1/2023 Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Internal review and update on 02/19/2024 by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. 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Coronary artery spasmVariant angina; Angina - variant; Prinzmetal angina; Vasospastic angina; Chest pain - PrinzmetalThe coronary arteries supply blood and oxygen to the heart. Coronary artery spasm is a brief, sudden narrowing of one of these arteries.Previous imagePlay SlideshowStop SlideshowNext image / Causes The spasm often occurs in coronary arteries that have not become hardened due to plaque buildup. However, it also can occur in arteries with plaque buildup.These spasms are due to a squeezing of muscles in the artery wall. They most often occur in just one area of the artery. The coronary artery may appear normal during testing, but it does not function normally at other times.About 2% of people with angina (chest pain and pressure) have coronary artery spasm.AnginaAngina is a type of chest discomfort or pain due to poor blood flow through the blood vessels (coronary vessels) of the heart muscle (myocardium). T...Read Article Now Book Mark Article Previous imagePlay SlideshowStop SlideshowNext image / 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:High cholesterolCholesterol is a fat (also called a lipid) that your body needs to work properly. Too much bad cholesterol in your blood can increase your chance of...ImageRead Article Now Book Mark Article High blood pressureBlood pressure is a measurement of the force exerted against the walls of your arteries as your heart pumps blood to your body. Hypertension is the ...ImageRead Article Now Book Mark Article Alcohol withdrawal Emotional stress StressStress is a feeling of emotional or physical tension. It can come from any event or thought that makes you feel frustrated, angry, or nervous. Stres...ImageRead Article Now Book Mark Article Exposure to cold Medicines that cause narrowing of the blood vessels (vasoconstriction) Stimulant drugs, such as amphetamines and cocaineCocaine use and cigarette smoking can cause severe spasms of the arteries. This causes 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). Symptoms Spasm may be "silent" (without symptoms) or it may result in chest pain or angina. If the spasm lasts long enough, it may even cause a heart attack.Related video goes here for no-HTML5 browsersThe main symptom is a type of chest pain called angina. Typically, the chest pain feels like tightness, heavy pressure, squeezing, or a crushing feeling. It may spread to the:Arm (most often the left) Back Jaw Neck ShoulderSome people say the pain feels like gas or indigestion. It is most often severe. The pain may spread to the neck, jaw, shoulder, or arm.The pain of coronary artery spasm:Often occurs at rest May occur at the same time each day, usually between midnight and 8:00 a.m. Lasts from 5 to 30 minutesThe person may lose consciousness.Chest pain and shortness of breath due to coronary artery spasm are often not caused by exercise, unlike angina that is caused by hardening of the coronary arteries. Exams and Tests Tests to diagnose coronary artery spasm may include:Coronary angiography Coronary angiographyCoronary angiography is a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through the arteries in your heart....ImageRead Article Now Book Mark Article Electrocardiogram (ECG) ElectrocardiogramAn electrocardiogram (ECG) is a test that records the electrical activity of the heart.ImageRead Article Now Book Mark Article Echocardiography Treatment The goal of treatment is to control chest pain and prevent a heart attack. A medicine called nitroglycerin (NTG) can relieve an episode of pain.Your health care provider may prescribe other medicines to prevent chest pain. You may need long term treatment with a type of medicine called a calcium channel blocker or a long-acting nitrate.Beta-blockers are another type of medicine that is used with other coronary artery problems. However, beta-blockers may make coronary artery spasm worse. They should be used with care.If you have this condition, you should avoid coronary artery spasm triggers. These include exposure to cold, cocaine or amphetamine use, cigarette smoking, and high-stress situations. Outlook (Prognosis) Coronary artery spasm is a long-term (chronic) condition. However, treatment most often helps control symptoms.ChronicChronic refers to something that continues over an extended period of time. A chronic condition is usually long-lasting and does not easily or quick...ImageRead Article Now Book Mark Article The disorder may be a sign that you have a high risk for heart attack or deadly irregular heart rhythms. The outlook is most often good if you follow your treatment, your provider's advice, and avoid certain triggers. Possible Complications Complications may include:Abnormal heart rhythms, which may cause cardiac arrest and sudden death Heart attacks When to Contact a Medical Professional Immediately call the local emergency number (such as 911) or go to the hospital emergency room if you have a history of angina and the crushing or squeezing chest pain is not relieved by nitroglycerin. The pain may be due to a heart attack. Rest and nitroglycerin often do not completely relieve the pain of a heart attack.A heart attack is a medical emergency. If you have symptoms of a heart attack, seek medical help right away.Heart attackMost heart attacks are caused by a blood clot that blocks one of the coronary arteries. The coronary arteries bring blood and oxygen to the heart. ...ImageRead Article Now Book Mark Article Prevention Take steps to reduce your risk of developing heart disease. Some studies have shown that making a few lifestyle changes can reduce your risk for heart disease. Lifestyle changes can also help prevent some angina attacks. Your provider may tell you to:Lose weight if you are overweight Stop smoking Exercise regularly Drink alcohol in moderation only Eat a healthy diet that is high in vegetables, fruits, whole grains, fish, and lean meatsYour provider will also recommend that you keep other health conditions such as high blood pressure, diabetes, and high cholesterol levels under control.Previous imagePlay SlideshowStop SlideshowNext image / Open ReferencesReferencesAmsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. Circulation. 2014;130(25):2354-2394. PMID: 25249586 pubmed.ncbi.nlm.nih.gov/25249586/.Boden WE. Angina pectoris and stable ischemic heart disease. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 56.Giugliano RP, Braunwald E. Non-ST Elevation Acute Coronary Syndromes. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 39.Ibanez B, James S, Agewall S, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the Management of Acute Myocardial Infarction in Patients Presenting with ST-segment Elevation of the European Society of Cardiology (ESC). Eur Heart J. 2018;39(2):119-177. PMID: 28886621 pubmed.ncbi.nlm.nih.gov/28886621/.Lange RA, Mukherjee D. Acute coronary syndrome: unstable angina and non-ST elevation myocardial infarction. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 57.Writing Committee Members, Gulati M, Levy PD, Mukherjee D, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the evaluation and diagnosis of chest pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2021;78(22):e187-e285. PMID: 34756653 pubmed.ncbi.nlm.nih.gov/34756653/.