Few quick defintion type questions

  * Does an angina attack last consistently for 15 minutes? Or can the pain come for a minute and then go, off and on for an hour or more? I guess what I'm asking is it more of a constant pain?
  * Also, does the heartrate ALWAYS increase during an angina attack? How much of an increase usually occurs? I mean, are we talking 160 or more, or just an increase?
  * Is adrenalin response responsible or a possible catalyst for coronary spasm?
  * Could the pain from coronary spasm last for 15 seconds and then be gone--or would it be more typical of a sustained angina?
  * what effect could Xanax have on coronary spasm, or angina in general besides the sedation?  Does it relax the smooth muscles of the heart or arteries or anything in addition to the "nerves"?
    I know these questions are somewhat disconjointed but thanks for answering them...

[CCF CARDIO MD APS]

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Dear Heather,
Angina can and does come and go, depending on the person, however, any angina lasting more than 20 minutes or so is likely to cause cardiac necrosis (a heart attack.)  And so it is very unusual for a person to have constant pain, or even pain for more than a half hour and not have a heart attack.  160 is awfully fast but possible, especially in the patient who is sedentary.
Heart rate should always increase somewhat when the patient is experiencing pain or some other kind of stress.
Adrenalin is thought to be a contributor of sorts in the coronary spasm patient, but certainly it does not work alone so to speak.
Coronary spasm pain can last any amount of time, and certainly is usually shorter rather than 'constant'.
I do not know Xanax to prevent the actual spasm mechanism, but surely its' relaxation effect is helpful in some patients with coronary spasm.  I am not qualified as a clinical cardiologist to comment on the potential mechanism of action of xanax, a good question for a pharm D.
I hope this information is useful. Information provided in the heart forum is for
general purposes only.  Only your physician can provided specific diagnoses and therapies.
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