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Coronary artery spasm


Alternative Names:

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

Exams and Tests:

Tests to diagnose coronary artery spasm may include:

Treatment:

The goal of treatment is to control chest pain and prevent a heart attack. A medicine called nitroglycerin can relieve an episode of pain.

Your health care provider may prescribe other medicines to prevent chest pain. You may need a type of medicine called a calcium channel blocker or a long-acting nitrate long-term. Your provider may also prescribe a short-acting nitrate to use during an episode of chest pain.

Beta-blockers are another type of medicine that is used with other coronary artery problems. However, beta-blockers may make this condition worse, and may be particularly harmful if used with cocaine.

Outlook (Prognosis):

Coronary artery spasm is a chronic condition. However, treatment most often helps control symptoms.

The disorder may be a sign that you have a high risk for heart attack or potentially deadly irregular heart rhythms (arrhythmias). The outlook is generally good if you follow your treatment recommendations and avoid certain triggers.

Possible Complications:

Complications may include:

  • Abnormal heart rhythms, which may cause cardiac arrest and sudden death
  • Heart attack
When to Contact a Medical Professional:

Immediately call your 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 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.

References:

Boden WE. Angina pectoris and stable ischemic heart disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 71.

Giugliano RP, Cannon CP, Braunwald E. Non-ST elevation acute coronary syndromes. In: Mann DL, Zipes DP, Libby P, et al, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 53.

Stern S, Bayes de Luna A. Coronary artery spasm: a 2009 update. Circulation. 2009 May 12;119(18):2531-4. PMID: 19433770 www.ncbi.nlm.nih.gov/pubmed/19433770.


Review Date: 4/20/2015
Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, 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 physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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