Coronary Artery Spasm - Causes, Symptoms, Diagnosis, Prevention

Coronary Artery Spasm

Dr.Otikunta Adikesava Naidu profile Authored by Dr.Otikunta Adikesava Naidu on 24 Oct 2014 - 11:47.

A coronary artery spasm (CAS) refers to a chronic heart condition indicated by sudden but temporary constriction of the arteries that causes obstruction in blood flow and thus renders the heart, deficit of oxygen.Although the condition is often temporary, it is quite brief and may lead to several severe complications. CAS may arise as a consequence of some other heart problems such as hypertension, elevated cholesterol, and so on. As it's a chronic condition, it does not go away on its own and often requires an effective medical approach to treat the condition.  These spasms are formed as a result of squeezing of the muscles of the artery wall, at a particular point. So during diagnosis, an artery may appear normal, but often has altered functions. About two out of 100 angina patients may have CAS.

In most of the cases, the basic cause of CAS is either high blood pressure or high levels of blood cholesterol. Patients with atherosclerosis (accumulation of fatty deposits in the artery causing blockage) may also experience the symptoms of CAS. CAS may occur without any specific cause or may get triggered by several factors. These may include:

  • Smoking and consuming alcohol (more than 100 ml/day)
  • Stress
  • Exposure to cold temperatures
  • Constant medications
  • Illegal drugs like cocaine

Majority of the CAS patients do not display any significant sign and may go undiagnosed until the symptoms become severe or may also lead to heart attack. Contrarily, some patients may experience some noticeable symptoms of CAS, whichinclude:

  • Light or significant chest pain, especially on the left side
  • Chest pain especially during rest (that too in the early morning or night)
  • Chest pain lasting for 5 to 30 minutes
  • Feeling heavy, pressurized or tightening in the chest
  • Radiating pain from chest to other nearby areas like neck, jaw or arms
  • Loss of consciousness.

Like any other disease or clinical condition, the diagnosis of CAS also begins with the physical examination and/ or assessment of health history and then several imaging and laboratory tests.

Assess health history – To look for presence of or history of any underlying health condition, which might be causing the CAS symptoms.

Electrocardiogram (ECG) – Toidentify any abnormalities in the heart with the help of specific electrical signals produced by the heart.

Coronary angiography – To detect and measure the exact amount of blood flowing through the heart 

Presence of or exposure to following factors may increase the risk of getting CAS. These may include:

  • Having any heart problem or disease
  • High cholesterol and high BP
  • Addictions like smoking, alcohol and drug abuse
  • Constant stress

Complications:

Undiagnosed, untreated or poorly managed CAS may lead to some long-lasting severe complications that may be life-threatening. These may include:

  • Abnormal heart beats, may be too fast or too slow (arrhythmia).
  • Heart attack.
  • Cardiac arrest or sudden cardiac death.
  • Death.

The treatment of CAS aims to encounter painful symptoms and severe complications like heart attack. Treatment approaches may include several medications, surgical approaches and may be some alternative approaches as a supporting therapy.

Medications:  Doctor may prescribe several medications like calcium channel blockers (CCBs), beta-blockers or nitrates, which are believed to offer relief from chest pain.

Medications to prevent heart attack – The doctor may prescribe anti-hypertensive medications and if found elevated cholesterol, you may be given medications belonging to statins (cholesterol lowering drugs)

Surgical approaches: These may include:

Stent implantation – When lifestyle modifications and medications do not work, the doctor may recommend stent implantation (a metal tube with a balloon is inserted into the artery and then inflated, to open the artery and regulate optimal blood flow).

Implantable cardiac defibrillators (ICD) – It is placed to treat the life-threatening arrhythmia by giving a series of electric shocks (by ICD) which may bring the heart to its normal rhythm.

Lifestyle modifications:

It has been well established that, healthy lifestyle and certain changes in daily routine are equally important to keep your heart healthy.  Here are the tips-

  • Eat healthy (see the diet recommendations)
  • Exercise daily (see the alternative approaches)
  • Maintain a healthy weight
  • Relax and stay calm

Alternative medicine:Following alternative approaches may help to deal with CAS and various other heart diseases:

Yoga and medications – It helps to keep you calm and relaxed also strengthens your heart. Talk to your yoga therapists and get yourself trained for particular yoga asanas that may be helpful.Examples- Shavasana, Vakrasana, SulabhUshtrasana, Pranayama, Neti, etc.

Acupuncture and acupressure – These may help to improve the life energy flow and thus relaxthe mind and strengthen the heart.

Exercise – Talk to your fitness trainer about beneficial exercises. Some common recommendations may include brisk walking, running, jogging, cycling and cleaning or gardening.

Diet recommendations:

  • Consume dietary supplements containing L-arginine, calcium and omega-3 fatty acids
  • Eat low sodium diet
  • Consume foods containing low amounts of fat, rather consume foods containing healthy fats like olive oil, fish oil, flax seeds etc.
  • Eat sufficient quantity of fruits and fresh vegetables (to get fibers and proteins)
  • Include fish and poultry products in your diet
  • Avoid red meat and deep fried foods
  • Avoid consuming excess salt / sodium containing foods
  • Limit the consumption of whole meat products

Following measures can be adapted to prevent the CAS or further complications:

  • Consume a low fat diet, even if you are healthy
  • Eat healthy and follow the dietary recommendations if suffering from heart ailment
  • Regular exercise is a must
  • Do not smoke or drink alcohol
  • Maintain a healthy weight
*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.