What is a coronary spasm?

Coronary spasm is a sudden narrowing or tightening of a small part of a coronary artery (an artery that supplies blood to the heart). As a result, your heart temporarily does not get enough oxygen and you feel a type of chest pain called angina.

This type of chest pain may be called Prinzmetal's angina, atypical angina, or variant angina.

How does it occur?

It is not known why these spasms occur. In young people, coronary spasms are most often related to the use of drugs, especially cocaine.

What are the symptoms?

Symptoms of coronary spasm include:

• chest pain or pressure that occurs when you are resting or awakens you from sleep

• palpitations (a sense of a rapid or irregular heartbeat) or other abnormal heart rhythms.

How is it diagnosed?

If your doctor suspects you are having coronary spasms, he or she will examine you and order an ECG (electrocardiogram). An ECG records your heart rhythms. The recording will show certain changes when you have pain caused by a coronary spasm. Your doctor may have you wear a small, portable ECG recorder, called a Holter monitor. It can record your heart rhythms for 24 to 72 hours.

You may also need a stress or treadmill ECG. During this type of ECG, the activity of your heart is recorded while you exercise on a stationary bike or treadmill.

You may need a coronary angiogram (a special x-ray where a medicine highlights the arteries). It can show blockages in your arteries. Sometimes it can show areas of spasm. During the test medication may be injected into your arteries to provoke spasm.

How is it treated?

The goal of treatment is to prevent or control symptoms. You and your doctor will develop a treatment plan that includes:

• stopping the use of drugs that cause coronary spasm

• learning about coronary spasm and gaining reassurance that it is a treatable condition

• medication to help prevent coronary artery spasm

• a review of your lifestyle and habits to reduce your risk factors for heart disease

• frequent follow-up appointments to check your progress.

How long will the effects last?

The effects will last as long as the cause of the spasm exists or until the spasm responds to medication.

How can I take care of myself and prevent coronary spasm?

To help take care of yourself:

• Follow your doctor's recommendations.

• Take your medication as directed.

• Report new or changing symptoms at once.

• Follow your doctor's advice for reaching or maintaining your ideal weight, blood pressure, blood sugar, and cholesterol levels and for getting enough exercise.

• Learn how anxiety and stress affect you. Learn methods to help you cope with stress.

To help prevent problems with coronary spasms, reduce your risk for heart disease as much as possible by:

• quitting smoking

• exercising regularly according to your doctor's advice

• avoiding drugs that cause spasms

• limiting caffeine and other stimulants

• reaching and maintaining your ideal weight

• eating foods that are low in cholesterol, low in fat, and high in complex carbohydrates and fiber.