What causes coronary artery spasm? Symptoms and natural treatment of Prinzmetal’s angina

By: Dr. Victor Marchione | Heart Health | Sunday, May 21, 2017 - 06:00 AM

coronary artery spasmCoronary artery spasm (Prinzmetal’s angina) is a type of angina that occurs at rest. It’s brought on by a spasm in the coronary artery, causing temporary narrowing of the artery. Although it can be relieved with medications, it is still a very severe condition. On an electrocardiogram, Prinzmetal’s angina—also called variant angina—appears with episodes of ST elevations.

Angina is characterized by tightness in the chest and chest pain because of reduced blood flow to the heart. Angina is not a disease on its own, but rather a symptom of coronary artery disease. Patients may experience tightness, pain, squeezing, pressure, or heaviness in the chest. For some, angina can be sudden, while in others, it can be a chronic condition.

Aside from variant angina, there is also stable angina and unstable angina. Stable angina is triggered by physical or emotional exertion. In unstable angina, plaque in the blood vessels ruptures or forms a blood clot, reducing or blocking blood flow. Unstable angina is not relieved by common medications, rather, it requires emergency treatment.

It’s important that angina is properly diagnosed and well managed to reduce the risk of complications and death.

What is Prinzmetal’s angina?

A coronary artery spasm is a temporary constriction of the muscles in the artery walls. When this occurs, blood flow becomes restricted, resulting in symptoms. A coronary artery spasm can decrease the amount of blood flowing through the artery or blocking the passageway altogether.

If a coronary artery spasm lasts for an extended period, it can result in angina or even a heart attack. Unlike stable angina, which is triggered by physical exertion, variant angina occurs while at rest, usually between the hours of midnight and early morning.

Coronary artery spasm: Causes, risk factors, and complications

The most common causes of coronary artery spasm are high cholesterol and high blood pressure. Nearly two percent of angina patients experience coronary artery spasm daily. Coronary artery spasms can also occur in patients with atherosclerosis, which is a condition characterized by narrowing of the arteries due to plaque buildup and resulting blood flow reduction.

Risk factors for coronary artery spasm include high blood pressure, high cholesterol, atherosclerosis, smoking, excess use of stimulants like illicit drugs, extreme stress, extreme cold, and alcohol withdrawal.

Although episodes of coronary artery spasm may be brief, they can lead to future health complications. If variant angina is left untreated, it can contribute to heart arrhythmias, heart attacks, cardiac arrest, and even death.

Symptoms of Prinzmetal’s angina

Symptoms of Prinzmetal’s angina include chest pain varying in severity, pain in the left side of your chest, chest tightness, and a feeling of constriction in the chest. Other symptoms may accompany coronary artery spasms, such as pain radiating from the chest to the neck, shoulders, or jaw, and pain that only occurs while at rest.

Diagnosing coronary artery spasm

Aside from a physical examination, your doctor will run other tests to better diagnose variant angina. These tests include:

  • Blood tests to check for cardiac biomarkers (troponin) and creatine kinase (CK) that leak from the damaged heart muscle
  • Electrocardiogram to see patterns in your heartbeats indicating reduced blood flow,
  • Echocardiography to produce images of your heart to check for angina-related problems,
  • Stress tests to make your heart work harder and angina easier to detect
  • Coronary angiography and heart catheterization to study the state of health and caliber of your arteries.

Prinzmetal’s angina treatment and prevention

Pain relief is the target of coronary artery spasm treatment.. Your doctor may put you on medications to reduce your risk of variant angina, including medications for high blood pressure.

Additionally, your doctor will recommend you adhere to a healthy lifestyle that involves healthy eating, exercising regularly, losing weight, not smoking, reducing your intake of alcohol, and reducing stress.

Prinzmetal’s angina home treatment

An experienced doctor should treat Prinzmetal’s angina because it’s a very serious condition. However, there are actions you can take to help manage the symptoms.

  • Avoid smoking: Smoking can cause the blood vessels in the body to constrict, leading to decreased blood flow. Smoking also promotes the build-up of plaque in the arteries that can complicate Prizmetal’s angina.
  • Manage stress levels: Stress leads to blood vessel constriction and possible worsening of Prinzmetal’s angina symptoms.
  • Avoid hyperventilation: Breathing too hard and for extended periods of time can be a trigger for symptoms.
  • Eat a healthy diet: Avoid meals high in saturated fats and choose sources of unsaturated fat such as olive or canola oil. Fish is also a good substitute for red meat. It is a good idea to avoid excessive consumption of refined carbohydrates. Healthy diets have decent servings of fresh fruit and dark green leafy vegetables.
  • Avoid severe cold: It is a clever idea to stay where it’s warm, as cold weather can create challenges for the cardiovascular system by constricting blood vessels.
  • Know your danger time zones: According to a study, Prinzmetal’s angina and several other cardiac conditions have a circadian rhythm and may follow a “24 hour” pattern, meaning they are more likely to occur at certain times.
  • Consider yoga or relaxation therapy: This is a fantastic way to lower stress, which can help reduce hyperactivity of the circulatory system.

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