Understanding Coronary Vasospasm
(A reversible cause of chest pain and reduced blood flow to the heart)
What is Coronary Vasospasm?
Coronary vasospasm, also called Prinzmetal’s angina or variant angina, occurs when a coronary artery suddenly tightens or spasms, narrowing the vessel and reducing blood flow to the heart.
Unlike a typical heart attack caused by plaque buildup or a blood clot, vasospasm results from abnormal contraction of the artery’s muscle. These episodes are often transient and reversible.
Who Gets Coronary Vasospasm?
Coronary vasospasm can affect people with or without coronary artery disease, but it is more commonly seen in:
Women, especially under age 60
People who smoke
Individuals with migraines, Raynaud’s phenomenon, or other vascular disorders
Those experiencing emotional or physical stress
Symptoms of Coronary Vasospasm
It can occur in people with or without coronary artery disease, but it’s more common in:
CMD often causes angina-like symptoms, but tests for blockages may come back “normal,” which can delay diagnosis.
How is it Diagnosed?
Since vasospasm may not show up during routine testing, diagnosis may involve:
Electrocardiogram (EKG) during an episode, showing temporary changes
Coronary angiography with a provocative test (e.g., with acetylcholine or ergonovine)
Ruling out fixed blockages with imaging
How is it Treated?
The goal is to prevent spasms and relieve symptoms:
Lifestyle Changes
Stop smoking and avoid secondhand smoke
Manage stress and avoid triggers (e.g., cold exposure, certain drugs)
Limit alcohol and stimulant use (like cocaine, amphetamines)
Medications
Calcium channel blockers (CCBs): main treatment to prevent spasm
Long-acting nitrates: help keep vessels open
Short-acting nitroglycerin: for relief during an episode
Statins if there’s underlying disease
Takeaway
Coronary vasospasm is a reversible and treatable cause of chest pain. If you experience chest pain at rest, especially at night or early morning, schedule a consultation with our team to evaluate for vasospastic angina. With proper treatment and lifestyle changes, symptoms can usually be controlled and heart health protected.
