Cardiac Sciences

Understanding and Treating Coronary Artery Spasms (Prinz Metal’s Angina)

admin Sep 20, 2024

Introduction

Coronary artery spasm is a temporary squeezing of the arteries. It is a condition that causes chest pain called angina. In this condition, less blood flows to the heart and other parts of the body. Coronary artery spasm is also referred to as Prinz metal’s angina, vasospastic angina, and variant angina. These are caused by clogged arteries, which are also a common cause of angina. This condition can increase the risk of heart attack and other heart complications.

Coronary artery: A brief note

Coronary arteries are the major blood vessels that supply blood to your heart. They are responsible for the heartbeat and pump blood through the body. There are two coronary arteries, the right and left coronary arteries, which are situated in the right and left parts of the heart, respectively. Each artery contains smaller branches that go deep inside the heart muscle. The main function of the coronary artery is to supply your heart with blood. The heart muscles need oxygen and nutrition in the blood so that they can pump blood through your heart and the rest of the body. The coronary arteries are situated around and inside the heart muscle. The coronary artery branches are the first of many branches of the aorta. They begin at the aortic root, which is the first part of the aorta that emerges from the left ventricle of the heart. The left ventricle is where the oxygenated blood leaves the heart and moves throughout the body.

Coronary artery spasm

It is a tightening or contraction of the arteries (coronary artery). Coronary arteries are the blood vessels of the heart that supply blood to the heart muscle. When these arteries contract, they decrease or block the blood flow to the heart. This leads to chest pain, known as angina. It is caused mostly in people with hypertension and hyperlipidaemia. It also occurs in people who smoke.

Causes

Certain heart conditions can cause coronary artery spasms, such as:

Atherosclerosis
High blood pressure
High cholesterol

Certain allergens that trigger coronary artery spasms include:

Tobacco use
Exposure to cold temperature
Extreme stress
Use of stimulants

Symptoms

The most common symptoms of coronary artery spasm are:

Chest burning
Chest pain
Chest pressure
Severe pain in arms, neck, shoulder, and back
Chest pain during midnight or early morning
Extreme pain on the left side of the chest
Chest tightness

Coronary artery spasms last for 5–30 minutes. This duration may vary for different people.

Diagnosis

Coronary artery spasms are diagnosed by healthcare providers using many techniques, including:

Ultrasound: It uses sound waves to take the image of the heart.
Electrocardiogram: It is a diagnostic technique that measures the heart’s electrical signals.
Coronary angiography: It comprises a special type of dye and imaging scans to watch the blood flow in the arteries.
Ambulatory monitor: It records the heart’s electrical activity on a daily basis.

Coronary artery spasm treatments

The main aim of the treatment is to prevent the blockages and relieve chest pain. The most common medications given to treat coronary artery spasm are:

Nitro-glycerine: It helps widen the arteries and improves blood flow
Calcium channel blockers: Such as amlodipine, diltiazem, and nifedipine
Statins: Such as atorvastatin and simvastatin (they lower the cholesterol levels)
Beta-blockers

Coronary artery spasm sometimes leads to an irregular heart rhythm in the lower chamber of the heart. This condition is called ventricular arrhythmia. To treat this condition, an implantable cardioverter defibrillator (ICD) is given as a medication. It uses electrical signals to keep the heartbeat regular.

Prevention

Simple ways to prevent coronary artery spasm are:

Avoid smoking
Consume less lipids, oils, and fats
Avoid drinking alcohol
Increase physical exercise
Healthy balanced diet
Consume nutritious food

Conclusion

Coronary artery spasms, also known as Prinz metal’s angina, encompasses temporary sudden contractions of coronary arteries, which can result in chest pain and increased risk of heart issues. While the chest pain is alarming, it can be easily managed with appropriate medical treatment and care. By following preventive measures and seeking timely medical care, one can manage their coronary artery spasms and have a better life.

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