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Intermediate Technical IVT

coronary vasospasm

Sudden, temporary narrowing of coronary arteries due to smooth muscle contraction, potentially causing angina or MI.

Full Definition

Coronary vasospasm, also known as coronary artery spasm or Prinzmetal's angina, involves the sudden constriction of epicardial coronary arteries or coronary microvessels due to smooth muscle contraction. This phenomenon can occur in normal or atherosclerotic vessels and may cause transient complete or subtotal vessel occlusion. Vasospasm typically presents as rest angina, often occurring in the early morning hours, and can lead to ST-elevation on electrocardiography and even myocardial infarction. Diagnosis may require provocative testing with agents like acetylcholine or ergonovine during cardiac catheterization. Treatment involves calcium channel blockers and nitrates, while avoiding beta-blockers which may exacerbate spasm.

Usage

Usage note: Can be written as one word 'vasospasm' or hyphenated 'vaso-spasm'; the former is preferred in current usage.

In Context

  • "Coronary vasospasm was suspected given the patient's typical rest angina and normal coronary anatomy." — Cardiology consultation
  • "Provocative testing with acetylcholine induced severe vasospasm in the left circumflex artery." — Cardiac catheterization report

Also known as

coronary artery spasm Prinzmetal's angina variant angina

Contrasted with

coronary vasodilatation

Don't confuse with

coronary thrombosis coronary dissection

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