Model Monday's: Diana Moldovan
What To Know About Artery Spasms
Coronary arteries are blood vessels that wrap around the heart and give blood and oxygen to the entire heart muscle. The walls of arteries have muscles themselves, and a coronary artery spasm is a tightening of those muscles. Depending on how long the spasm lasts, the blood flow to your heart can either be limited or completely blocked.
Usually, a coronary artery spasm will take place in an artery that is not clogged with plaque buildup, but it can also happen with arteries that do have plaque inside them. It also typically only happens in one part of the artery.
These spasms usually happen suddenly and can be brought on by:
Among the strongest triggers of coronary artery spasms are cigarette smoking and stimulants. In particular, cigarette smoking significantly increases your chances of getting arterial spasms and quitting smoking decreases your chances.
But sometimes when a spasm occurs, there is no cause to point to.
Coronary arterial spasms usually have no symptoms unless they're strong enough to cause chest pains. You may feel such pain during physical activities or stress. But it should be noted that only 2% of people who have chest pain are experiencing a coronary artery spasm or variant angina.
Variant Angina. When you have chest pain that is due to not enough blood flow to the heart, you are said to have angina. A coronary artery spasm that involves pain can bring on a rare condition called variant angina. It's also called Prinzmetal's or Prinzmetal angina, or angina inversa.
Variant angina usually happens in younger people who do not have any other type of heart condition, and it can affect them during rest. And because chest pain is usually a sign that you have heart disease, it is important that you seek medical treatment if you think you are experiencing variant or any other type of angina.
Usually, if you feel chest pain from a coronary artery spasm, you will feel it under the sternum (breast bone), on the left. This pain is very intense, and it can feel like your chest is being squeezed. Occasionally, these sensations can spread to other parts of the body like the neck, arm, shoulder, or jaw.
Coronary artery spasms usually happen during sleep at the same time each day. They can last for up to 30 minutes and sometimes result in a loss of consciousness.
After you go to the doctor and describe your symptoms, your doctor will give you some tests.
An electrocardiogram. This tests the electrical signals of your heart. It requires no preparation and does not take very long to conduct. Electrocardiograms can detect abnormal heart patterns both during a spasm and after one.
Echocardiogram. An echocardiogram is essentially an ultrasound for the heart. Your doctor will be able to map out your heartbeat through a sonic test. They will place a wand on the top of your chest that can pick up high-frequency sound waves. These sounds allow them to paint a picture of the different parts of your heart.
Coronary angiography. This may be the best way to detect if you have a coronary artery spasm. This test involves a procedure in which your doctor will inject contrast dye into a blood vessel.
The doctor will then take an X-ray of your heart. The X-ray will show whether you have any blockages.
Ambulatory monitor. You may need to spend 24 hours or more on an ambulatory monitor, a device that records your heart rhythms as you go about your business. The monitor will show your doctor your heart's patterns and possible spasms at all times of the day.
The risks of coronary artery spasms are quite significant. Depending on how bad the blockage is, you are at risk for several different conditions, including cardiac arrest, organ failure, heart failure, or even sudden death. While having spasms is a chronic condition, there are many treatment plans out there that can keep you safe.
You must consult your doctor to find out what would be right for you. Still, some of the most common medications prescribed are:
In addition to medication, you should also make these lifestyle changes (if you haven't already):
Harvard Health Publishing And 3 Experts Weigh In On: What Happens If Coronary Artery Disease Is Left Untreated?
© Provided by Getty Images M.D. Chief Medical Editor, Harvard Health Publishing · 40 years of experience · USA Coronary artery disease (CAD) is most often caused by fatty plague buildup in the walls of the arteries, which reduces blood flow to heart muscle cells. You can prevent developing CAD by doing the following: • Quit smoking • Eat a healthy diet • Reduce your LDL (bad) cholesterol • Reduce high blood pressure • Lose weight • Exercise. If left untreated, the coronary arteries will continue to build plaque, increasing the risk of developing problems such as angina, having a heart attack and damaging heart muscle cells enough to cause heart failure.
→ See more questions and expert answers related to coronary artery disease.
→ Learn more about coronary artery disease: See the causes, symptoms, treatment options and more.
DO, MPH · 16 years of experience · USAIf left untreated, CAD can develop into a variety of additional cardiac problems, some of which can be fatal: Shock caused by the heart: After a serious insult to the heart muscle, this life-threatening emergency might occur. A cardiac attack or a severe arrhythmia are examples of this type of harm (irregular heart rhythm).
→ See more questions and expert answers related to coronary artery disease.
→ Learn more about coronary artery disease: See the causes, symptoms, treatment options and more.
MBBS · 4 years of experience · IndiaCoronary Artery Disease can lead to Myocardial infection. There may be chances if Heart Failure. Arrhythmias are common if CAD left untreated. Ultimately these complications lead to death.
→ See more questions and expert answers related to coronary artery disease.
→ Learn more about coronary artery disease: See the causes, symptoms, treatment options and more.
MBBS,DNB psychiatry · 6 years of experience · IndiaUntreated coronary artery disease can lead to multiple heart problems. It can lead to arrhythmias. Severe cases can lead to Heart failure. Increased incidence of clots in blood when there is no good flow in circulation can increase risk of stroke and pulmonary embolism.
→ See more questions and expert answers related to coronary artery disease.
→ Learn more about coronary artery disease: See the causes, symptoms, treatment options and more.
What's Causing My Chest Pain?
Chest pain is not something to ignore. But you should know that it has many possible causes. In many cases, it's related to the heart. But chest pain may also be caused by problems in your lungs, esophagus, muscles, ribs, or nerves, for example. Some of these conditions are serious and life threatening. Others are not. If you have unexplained chest pain, the only way to confirm its cause is to have a doctor evaluate you.
You may feel chest pain anywhere from your neck to your upper abdomen. Depending on its cause, chest pain may be:
Here are some of the more common causes of chest pain.
These heart problems are common causes:
Coronary artery disease, or CAD. This is a blockage in the heart's blood vessels that reduces blood flow and oxygen to the heart muscle. This can cause pain known as angina. It's a symptom of heart disease but typically does not cause permanent damage to the heart. It is, though, a sign that you are at risk for a heart attack in the future. The chest pain may spread to your arm, shoulder, jaw, or back. It may feel like a pressure or squeezing sensation. Angina can be triggered by exercise, excitement, or emotional distress and is relieved by rest.
Myocardial infarction (heart attack). This reduction in blood flow through heart blood vessels causes the death of heart muscle cells. Though similar to angina chest pain, a heart attack is usually a more severe, crushing pain usually in the center or left side of the chest and is not relieved by rest. Sweating, nausea, shortness of breath, or severe weakness may accompany the pain.
Myocarditis. In addition to chest pain, this heart muscle inflammation may cause fever, fatigue, fast heart beat, and trouble breathing. Although no blockage exists, myocarditis symptoms can resemble those of a heart attack.
Pericarditis. This is an inflammation or infection of the sac around the heart. It can cause pain similar to that caused by angina. But it often causes a sharp, steady pain along the upper neck and shoulder muscle. Sometimes it gets worse when you breathe, swallow food, or lie on your back.
Hypertrophic cardiomyopathy. This genetic disease causes the heart muscle to grow abnormally thick. Sometimes this leads to problems with blood flow out of the heart. Chest pain and shortness of breath often occur with exercise. Over time, heart failure may occur when the heart muscle becomes very thickened. This makes the heart work harder to pump blood. Along with chest pain, this type of cardiomyopathy may cause dizziness, lightheadedness, fainting, and other symptoms.
Mitral valve prolapse. Mitral valve prolapse is a condition in which a valve in the heart fails to close properly. A variety of symptoms have been associated with mitral valve prolapse, including chest pain, palpitations, and dizziness, although it can also have no symptoms, especially if the prolapse is mild.
Coronary artery dissection. Many things can cause this rare but deadly condition, which results when a tear develops in the coronary artery. It may cause a sudden, severe pain with a tearing or ripping sensation that goes up into the neck, back, or abdomen.
These are common causes of chest pain:
Pleuritis. Also known as pleurisy, this is an inflammation or irritation of the lining of the lungs and chest. You likely feel a sharp pain when you breathe, cough, or sneeze. The most common causes of pleuritic chest pain are bacterial or viral infections, pulmonary embolism, and pneumothorax. Other less common causes include rheumatoid arthritis, lupus, and cancer.
Pneumonia or lung abscess. These lung infections can cause pleuritic and other types of chest pain, such as a deep chest ache. Pneumonia often comes on suddenly, causing fever, chills, cough, and pus coughed up from the respiratory tract.
Pulmonary embolism. When a blood clot travels through the bloodstream and lodges in the lungs, this can cause acute pleuritis, trouble breathing, and a rapid heartbeat. It may also cause fever and shock. Pulmonary embolism is more likely following deep vein thrombosis or after being immobile for several days following surgery or as a complication of cancer.
Pneumothorax. Often caused by an injury to the chest, pneumothorax happens when a part of the lung collapses, releasing air into the chest cavity. This can also cause pain that gets worse when you breathe as well as other symptoms, such as low blood pressure.
Pulmonary hypertension. With chest pain resembling that of angina, this abnormally high blood pressure in the lung arteries makes the right side of the heart work too hard.
Asthma. Causing shortness of breath, wheezing, coughing, and sometimes chest pain, asthma is an inflammatory disorder of the airways.
COPD. This includes one or more of three disease: Emphysema, chronic bronchitis, and chronic obstructive asthma. The disease blocks airflow by shrinking and damaging both the airways that bring gases and air to and from your lungs and the tiny air sacs (alveoli) that transfer oxygen to your bloodstream and remove carbon dioxide. Smoking is the most common cause.
Gastrointestinal problems can also cause chest pain and include:
Gastroesophageal reflux disease (GERD). Also known as acid reflux, GERD occurs when stomach contents move back into the throat. This may cause a sour taste in the mouth and a burning sensation in the chest or throat, known as heartburn. Things that may trigger acid reflux include obesity, smoking, pregnancy, and spicy or fatty foods. Heart pain and heartburn from acid reflux feel similar partly because the heart and esophagus are located close to each other and share a nerve network.
Esophageal contraction disorders. Uncoordinated muscle contractions (spasms) and high-pressure contractions (nutcracker esophagus) are problems in the esophagus that can cause chest pain.
Esophageal hypersensitivity. This occurs when the esophagus becomes very painful at the smallest change in pressure or exposure to acid. The cause of this sensitivity is unknown.
Esophageal rupture or perforation. A sudden, severe chest pain following vomiting or a procedure involving the esophagus may be the sign of a rupture in the esophagus.
Peptic ulcers. A vague, recurring discomfort may be the result of these painful sores in the lining of the stomach or first part of the small intestine. More common in people who smoke, drink a lot of alcohol, or take painkillers such as aspirin or NSAIDs, the pain often gets better when you eat or take antacids.
Hiatal hernia. This common problem occurs when the top of the stomach pushes into the lower chest after eating. This often causes reflux symptoms, including heartburn or chest pain. The pain tends to get worse when you lie down.
Pancreatitis. You may have pancreatitis if you have pain in the lower chest that is often worse when you lie flat and better when you lean forward.
Gallbladder problems. After eating a fatty meal, do you have a sensation of fullness or pain in your right lower chest area or the right upper side of your abdomen? If so, your chest pain may due to a gallbladder problem.
Sometimes chest pain may result from overuse or an injury to the chest area from a fall or accident. Viruses can also cause pain in the chest area. Other causes of chest pain include:
Rib problems. Pain from a broken rib may worsen with deep breathing or coughing. It is often confined to one area and may feel sore when you press on it. The area where the ribs join the breastbone may also become inflamed.
Muscle strain. Even really hard coughing can injure or inflame the muscles and tendons between the ribs and cause chest pain. The pain tends to persist and it worsens with activity.
Shingles. Caused by the varicella zoster virus, shingles may prompt a sharp, band-like pain before a telltale rash appears several days later.
Another potential cause of chest pain is anxiety and panic attacks. Some associated symptoms can include dizziness, sensation of shortness of breath, palpitations, tingling sensations, and trembling.
When in doubt, call your doctor about any chest pain you have, especially if it comes on suddenly or is not relieved by anti-inflammatory medications or other self-care steps, such as changing your diet.
Call 911 if you have any of these symptoms along with chest pain:
Call your doctor if you have any of these symptoms:
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