What should you know about angina spasm?

Also called vasospastic angina, it can occur without exertion and may follow a recurring pattern. Prompt assessment matters because new or severe chest symptoms can also reflect a heart attack.

A muscle layer surrounds each coronary artery. If that muscle suddenly contracts, the artery narrows and less oxygen-rich blood reaches part of the heart. The episode may produce pressure, squeezing, burning, or tightness in the chest, sometimes with discomfort in an arm, shoulder, jaw, neck, back, or upper abdomen.

Episodes may happen at rest, during the night, or in the early morning. Smoking, stimulant drugs, cold exposure, emotional stress, and some medicines can provoke spasm in susceptible people, although a trigger is not always found.

Stop what you are doing and rest. If you have been prescribed a fast-acting angina medicine, use it exactly as your clinician instructed. Record when the discomfort began, what it felt like, how long it lasted, possible triggers, and whether medicine helped.

Arrange medical review even if the episode settles, particularly when symptoms are new or changing. Assessment may include a symptom history, an electrocardiogram, blood tests, and tests that examine heart rhythm or coronary blood flow. Do not start, stop, or change heart medicines without clinical advice.

Call emergency services for chest pressure or tightness that is severe, new, persistent, worsening, or accompanied by breathlessness, sweating, nausea, faintness, or discomfort spreading to the arm, jaw, back, or shoulder. Do not drive yourself. Follow your emergency angina plan if you have one, but do not delay calling when symptoms do not settle as expected.

Ask whether the timing of your episodes suggests coronary spasm, which tests could capture changes during symptoms, what triggers to avoid, and exactly how to use prescribed rescue medicine. Clarify which symptom changes should prompt an emergency call and whether your other medicines could affect blood vessels.