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Coronary Artery Vasospasm


Coronary artery vasospasm, or smooth muscle constriction of the coronary artery, is an important cause of chest pain syndromes that can lead to myocardial infarction (MI), ventricular arrhythmias, and sudden death. It also plays a key role in the development of atherosclerotic lesions.

In 1959, Prinzmetal et al described a syndrome of nonexertional chest pain with ST-segment elevation on electrocardiography (ECG).
Unlike patients with typical angina, these patients characteristically had normal exercise tolerance, and their pain patterns tended to be cyclical, with most episodes occurring in the early morning hours without regard to cardiac workload. This syndrome became known as Prinzmetal or variant angina, and was believed to be due to vasospasm in coronary arteries without obstructive lesions.

Subsequently, Maseri et al described the clinical, ECG, and angiographic features of 138 patients with variant angina and concluded that the syndrome was considerably more polymorphic than was initially inferred by Prinzmetal.

For patient education resources, see the Heart Health Center and Chest Pain.

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