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Coronary artery spasm


Alternative Names:

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

Signs 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 medications to prevent chest pain. You may need a type of medicine called a calcium channel blocker long-term. Your doctor may prescribe long-acting nitrates along with the calcium channel blocker.

Beta-blockers are another type of medication that may be used. However, beta-blockers may make the condition worse and may be harmful if used with cocaine.

Expectations (prognosis):

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

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

Complications:
  • Abnormal heart rhythms, which may cause cardiac arrest and sudden death
  • Heart attacks
Calling your health care provider:

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 immediate medical help.

References:

Boden WE. Angina pectoris and stable ischemic heart disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 71.

Cannon CP, Braunwald E. Unstable angina and non-ST elevation myocardial infarction. In: Bonow RO, Mann DL, Zipes DP, Libby P, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: WB Saunders; 2011:chap 56.

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


Review Date: 6/4/2012
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutiosn, Ebix, Inc.

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