For the past two years, Cong has experienced frequent chest pain. The pain is sudden, mainly occurring at rest, at night, or in the early morning. Recently, his condition worsened, with episodes occurring about 10 times daily, accompanied by jaw stiffness, numbness in both arms, and transient shortness of breath.

Dr. Nguyen Tuan Long, from the Department of Cardiology at Tam Anh General Hospital Hanoi, noted that Cong's symptoms were consistent with coronary artery spasm. This functional condition is often challenging to detect using standard diagnostic methods such as echocardiography or electrocardiograms. Many patients experience chest pain similar to coronary artery disease, yet tests reveal no physical heart damage or arterial narrowing due to atherosclerosis.

Cong underwent coronary angiography combined with an ergonovine test, a procedure using medication to stimulate the coronary arteries and detect spasms. The results revealed a significant spasm in his right coronary artery, temporarily obstructing blood flow. Upon receiving vasodilators, the coronary artery rapidly relaxed.

Doctors prescribed medical treatment for Cong using vasodilators to manage the coronary artery spasms, which led to a notable reduction in his chest pain.

Doctors perform an ergonovine test to identify coronary artery spasm in a patient. Photo: Tam Anh General Hospital

According to Dr. Long, coronary artery spasm occurs when the heart's arteries suddenly and transiently contract, reducing blood flow to the heart muscle and causing chest pain. Unlike coronary artery disease resulting from atherosclerosis, the arteries are not permanently narrowed or blocked; instead, they experience spasms at specific times.

The exact cause of the condition remains unclear but is associated with vascular endothelial dysfunction and heightened coronary artery sensitivity to stimuli. It can affect young individuals who may not present typical cardiovascular risk factors. Additional risk factors include smoking, chronic stress, sleep disorders, weather fluctuations, alcohol consumption, and certain medications.

Without proper treatment, coronary artery spasm can lead to dangerous cardiovascular events. Prolonged or recurrent spasms significantly reduce blood supply to the heart muscle, potentially causing arrhythmias, acute myocardial ischemia, and persistent chest pain.

Dr. Long emphasizes that coronary artery spasm can be prevented and managed if patients avoid triggering risk factors. Individuals should maintain a balanced lifestyle, engage in moderate exercise, eat healthily, manage stress, adhere to prescribed medical treatment, and attend regular follow-up appointments.

Ly Nguyen

*Patient's name has been changed.