Prinzmetal angina: coronary artery spasm explained

A coronary artery briefly tightens, reducing oxygen-rich blood reaching part of the heart muscle. Unlike classic exertional angina, episodes may appear at rest and can follow a recurring pattern, sometimes overnight or early in the morning. A person may also have plaque-related narrowing, but a major fixed blockage is not required for spasm to occur.

Describe the timing, duration, triggers, and associated symptoms precisely. An ECG recorded during discomfort can reveal temporary changes, while further testing may assess the coronary arteries or provoke spasm under controlled specialist conditions. Medicines that relax coronary vessels are commonly considered. Avoid smoking and recreational stimulants, and review all prescription, non-prescription, and migraine medicines because some substances can promote vessel constriction. Follow the prescribed episode plan exactly.

Call emergency services for a first episode of significant chest pain, severe or persistent pressure, symptoms that fail to improve as your clinician instructed, or discomfort with breathlessness, sweating, nausea, collapse, or spreading pain. It is not possible to safely distinguish coronary spasm from a heart attack based only on how the pain feels.

Ask whether your episode pattern suggests spasm, which tests could capture it, and whether any current medicine could contribute. Confirm when and how to use rescue medication, which substances to avoid, and what to do if the usual pattern changes. Report palpitations or fainting because spasm can sometimes disturb heart rhythm.