Introduction:
Coronary artery vasospasm is a clinical condition characterized by the sudden tightening of the muscles present within the arteries of the heart. This condition leads to the narrowing of the arteries and prevents blood from flowing to the heart. Coronary artery spasms are also called coronary artery contractions. It is a temporary condition that exists for a short duration. However, it is capable of causing further complications in the heart, such as heart attack. In addition, patients with high cholesterol or high blood pressure are at increased risk of these spasms.
What Are the Causes of Coronary Artery Vasospasm?
Various research on this topic has not revealed the exact cause of this vasospasm. However, there are various contributing factors, as mentioned below:
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Autonomic Nervous System - This is responsible for controlling involuntary processes in the body, like heart rate and blood pressure. As coronary artery spasms often happen at night, researchers suspect this system can cause it due to activation by the neurotransmitter acetylcholine and the catecholamine hormone. However, the exact mechanism is not clearly understood.
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Oxidative Stress - This can lead to inflammation, damage to endothelial cells, and narrowing of vascular walls. In addition, smoking can be associated with this type of stress.
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Genetics - Although not clearly understood, it is thought to be observed in a few. Also, there is no genetic test available for evaluation of the same.
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Endothelial Cells - These are the cells present inside the heart. In some people, these cells may not produce sufficient nitric oxide and, thus, may cause spasms.
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Functioning of Smooth Muscles - The heart comprises smooth muscles, and more research is required to understand the effects of these muscles.
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Inflammation - It can also be associated with this condition indirectly.
What Are The Signs And Symptoms?
Most coronary artery vasospasms do not show apparent symptoms; thus, they go undiagnosed. If left undiagnosed, these contractions can lead to a heart attack. However, the patient may experience slight chest pain rarely.
Some patients may show various other symptoms as the following:
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Tightness in the chest.
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Chest pain or angina.
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Pain on the left side of the chest.
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Constriction or spasm feeling.
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Radiating pain can get transferred from the chest to the arms, neck, or jawbone.
Hence, if a person experiences any of the below-mentioned symptoms, coronary artery vasospasms can be suspected, such as, chest pain that -
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Occurs more commonly at night or early in the morning.
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Occurs during rest.
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The duration lasts from five minutes to nearly 30 minutes at a time.
Are There Any Risk Factors?
A person may have an increased risk for coronary artery spasms if they are more prone to developing heart disease. High cholesterol and high blood pressure are directly associated with an increased risk of arterial constriction. Various activities can increase the risk of coronary artery spasms. They are as follows -
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Extreme cold.
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Increased use of stimulants like cocaine and amphetamines.
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High stress.
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Alcohol withdrawal.
How Can It Be Diagnosed?
The initial assessment starts by asking about the person's signs and symptoms, personal history, and medical and family history. Then, as this condition affects the heart, the physician will order a few imaging tests. This imaging will help understand the condition, like the site and extent, and also helps in diagnosis and treatment planning.
The diagnostic imaging tests that may be used are as follows -
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Electrocardiogram (EKG) - It is a test used to measure the electrical activity of the heart.
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Echocardiogram - It is an ultrasound test that utilizes sound waves to form pictures of the heart.
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Coronary Angiography - It is a procedure that involves injecting a dye through a small tube injected into an artery going toward the heart. Then, the images are taken.
How Can It Be Treated?
The main way of managing coronary artery vasospasm is to relieve chest pain. This mainly includes medications prescribed by the physician. They are as follows -
1) Nitrates
They can help dilate the arteries and relax the artery walls. This medication can be used as long-term or emergency pills if another spasm occurs.
2) Calcium Channel Blockers
They help reduce tightness in the chest by relaxing the muscles in the arteries. This medication can also be taken on a long-term basis. The doctor may also prescribe certain medications to help reduce high cholesterol or high blood pressure. Consumption of these medications will work toward preventing another coronary artery vasospasm or heart attack. It is essential to consume a low-fat, low-sodium diet when undergoing treatment. Smoking should be avoided. These healthy lifestyle changes can assist in preventing another spasm attack.
What Is the Prognosis of Coronary Artery Vasospasms?
It can remain for a chronic duration, although the attacks are short-lived. The prognosis can be good if the patient maintains a healthy lifestyle and follows the physician's instructions, along with regular medications if prescribed.
Are There Any Complications Associated With This Condition?
Coronary artery spasms are transient and short-lived. However, they can lead to lasting consequences.
Untreated coronary artery vasospasms may lead to a worsening of the condition and may lead to any of the below -
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Heart Arrhythmias - This indicates irregular heartbeats. It can also cause slow or fast beats.
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Myocardial infarction or Heart Attacks - Complete blockage of the blood flow to the heart may lead to this.
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Cardiac Arrest or Death - It is the sudden cessation of the heartbeat and may lead to death if not managed immediately.
What Are The Ways To Prevent It?
The risk of coronary artery vasospasms can be reduced by preventing atherosclerosis. This can be done by eating a low-fat diet, exercising regularly, controlling blood pressure, and quitting smoking. Also, avoiding triggering factors or stress can be beneficial. It is essential to follow the instructions of the physician for a better prognosis.
Conclusion:
Coronary artery vasospasm affects the heart, and if not managed on time, it can lead to severe complications.
