Re: Spasm of the RCA

Posted By CCF CARDIO MD - MTR on March 10, 1998 at 15:01:53:

In Reply to: Spasm of the RCA posted by Mariette on March 03, 1998 at 14:18:37:







: Hello!
I posted a message before re. the recurrent DVT. Thanks for your reply.
BUT: during a catheterization they detected a severe spasm of the RCA. I immediately was given nitro-spray but even two dosages were not really sufficient. Now is my question: can this happen again? I sometimes suffer chest pains, but I always tell myself not to think about it and not to bother. I know that several bloodvessels tend to go into a spasm, but these are just small veins. But the news re. the RCA was surprising. Should I pay more attention to the chest pains? And again: could it happen again?
Thanks very much for your reply!
Mariette






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Dear Mariette, thank you for your question - I remember your first question well.  
Coronary artery spasm certainly occurs (as you found out) but we are unsure of the
causes.  Cigarette smoking is associated with spasm so that should be avoided and high
cholesterol can lead to plaque build-up in the arteries that can also cause spasm.  When
spasm occurs, the smooth muscle surrounding the coronary artery contracts and the
lumen of the artery is blocked off transiently.  Treatment consists of nitroglycerin
preparations or calcium channel blockers that dilate the smooth muscle and restore
the lumen to provide good blood flow to the heart muscle.  If you are having recurrent
chest pain and you had no severe narrowings of the coronary arteries, then spasm needs
to be considered as a cause.  You may benefit from treatment with a calcium channel
blocker or long-acting nitroglycerin preparations and you shouldn't ignore recurrent chest
pains.  There is a disorder called Syndrome X (detailed in a response in the Heart Forum
on 2/17/98) where the coronary arteries are normal but the small arteries not easily
visualized during a cath are thought to spasm to cause chest pain.  Calcium channel
blockers are also the treatment of choice in this condition.  I suggest that you see your
cardiologist soon to discuss your recurrent chest pain as spasm certainly could happen
again.  I hope you find this information helpful.
Information provided in the Heart Forum is for general purposes only.   Specific diagnoses
and therapies can only be provided by your physician.