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Coronary Artery Spasm
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Coronary Artery Spasm

My husband has been diagnosed with coronary artery spasms.  He has had periodic chest pain for the past 5 months which has been relieved with nitro.  His stress test was positive.  So, they did a cath which showed clean coronaries.  He was then started on norvasc, aspirin, an ace inhibitor for BP.  He does have a moderate elvation of blood pressure. Currently he has less chest pain but does still have periodic episodes where he takes nitro.  Could you tell me more about coronary artery spasms?  What is usually the treatment for them?   What is the prognosis or how serious is this problem?  Is there anything besides medications that may be helpful?  Thank you very much.
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74076_tn?1189759432
Hi Dotty,

Variant angina or coronary spasm is relatively rare, but recongnized entity that causes chest pain syndromes.  


Could you tell me more about coronary artery spasms?

The mechanism of coronary spasm is not known but possibilities include dysregulation of the cells lining the arteries (endothelial cells), autonomic dysfunction particularly of the sympathetic nervous system and inflammation.

The usually treatment consists of nitrates and calcium channel blockers like norvasc.  Statins also improve endothelial function and are another treatment consideration, but there are no current guidelines suggesting this.

The prognosis for coronary spasm in patients with angiographically normal coronary arteries is said to be better than those with angiographic coronary disease.  I did not see an article predicting a worse long term outcome with spasm.

It sounds like he is being treated appropriately for now.

Good luck and I hope he feels better soon.
8 Comments
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Avatar_n_tn
Hi Dotty,  I read your post and I'm sorry to hear about your husband having coronary spasms. I use to get them from time to time.  For some reason - they would just come on for a couple mos and then I might not see them again for a couple years.  Years later they came back and once again they went..  

They are very painful and I would swear I was having a heart attack - its such a 'tight twisting' feeling.  I didn't have enough significant arterial plaque to warrant any stents - thank god...  I was given some meds like your husband - only I didn't tolerate them well - and since they went away I didn't pursue it.  

Maybe its just a coincidence but since I've been taking "Pravachol" for my cholesterol - its been a couple years now - I haven't had any spasms.  

I do know when I got arterial spasms they were 'awful' and NITRO did not help relieve the pain at all for me.  Just some deep breathing and relaxation techniques worked the best.  

I'm sure the good docs here will provide some suggestions...

Best Wishes
Marilyn  (runner)
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Avatar_n_tn
I ha d a coranary spasm last july 20o4. I have been on calcium channel blockers since. I have had no spasms since then and besides my normal pvc and arrythmias am doiing fine. Good luck
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Avatar_n_tn
ok i have been using methamhetamine for the past 6 months on and off but i get these spasms or tremors not sure wut it is around my heart muscles like on the top right where the heart is and sometimes  in the middle of my chest but it scares me. like its a big jolt or shock it feels like. it happens when i use meth and sometimes now when im off of it i get those. now i do have anxiety disorder and i get panic attacks so im not sure if what im experiencing is anxiety and i know i shouldnt be using meth but im not sure what this is? anyone know?
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Avatar_n_tn
from what i learned about spasms, they can be caused by stress as mine was, or due to drug use. Crack and meth were the 2 mentioned in the article I read. Please get help. These spasms can evenutally hurt or kill you if untreated.I myself had some minor damage to my heart and I called 911 within 10 minutes of the pain. good luck
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Avatar_n_tn
I've been doing a lot of research on coronary spasm and all pointers are indicating that this is what I've been experiencing.

Before last October I was in excellent shape (biked to work 5 days a week 3 miles, weight trained 3 days a week, and ran 5K three days a week at the gym) and at 35 years old, I *never* experienced any heart related problems.

The beginning of October, I started going through some intense stress... I was forced to stop working out due to some physical injury.  Toward the end of October, I experienced a scary situation involving intense left jaw pain with radiating left arm pain and numbness.  I went to the emergency room.  They never looked at my heart, but thought it was a possible stroke.  All tests for stroke came back negative, and I felt a little foolish for even going in to the emergency room.

Then two months later, I woke at 4am with intense chest pain that would be horrible for 2 to 3 minutes and then go completely away for 20 to 25 minutes.  It would then repeat the cycle.  Each time the pain would come on very quickly and then go away about as quickly.  This continued throughout the day and progressively got worse.  

Finally at 8pm that night, I went back to the emergency room.  They again did not suspect my heart.  The resident kept on telling me that I was not having a heart attack and that I shouldn't worry.  The pain was not going away and morphin and nitro wasn't helping.  As they eliminated things (blood clot, etc.) they called more doctors from cardiology and finally determined from my heart attack enyzme that I was having a heart attack.  This was now Midnight.

They performed an emergency cath and placed two stents in my LED artery.  

Since then, I've continued to have similar episodes, only not quite so severe.  I went back to the hospital in April where they performed another cath and determined everything looked normal.

Since April, I continued to have epsiodes.  Then a few weeks ago, I was suggested by a nurse at my cardiac rehabilitation that I was experiencing a coronary spasms.  I did research and determined that I should be on a CCB.  I called my cardiologist and was prescribed Norvasc (5mg).  Since I started taking Norvasc, I have had no further episodes.

-Mike

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Avatar_n_tn
I am a 39-y.o. female and 3 mths ago went into ER with chest pain at approx 3:30 am and at 11:00 am was finally diagnosed with a MI.  I also had two stents placed.  

They believed that it was a coronary spasm as I really had very few risk factors.  Of course, there is no way to prove anything anyway so we will never know for sure.  I am on a CCB, ACE inhibitor, statin, beta blocker, nitro etc and I still have weird things happen but I am sure they are from all the drugs in my system.  I occasionally still have "twinges" but they are so much less than they were and I can usually tie them to being tired or stressed.  I am learning to manage my life better and have taken a yoga class and do reflexology occasionally to help to "de-stress."

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