Can you have angina pectoris even if you don't have coronary heart disease? Beware of fatal coronary artery spasm

A friend in his 40s told Huazi that he had encountered something that frightened him greatly. When he was attending a class reunion, one of his classmates suddenly said that his chest hurt, and then he sat down on the ground, his face was pale, his lips were blue, and he soon lost consciousness. After calling "120", the ambulance arrived at the scene more than ten minutes later, but his classmate still died in the end. The doctor said it was sudden cardiac death.

He said his classmate was in good health, his physical examination indicators were normal, and he had no coronary heart disease. How could he suddenly have angina pectoris and then die suddenly? The doctor speculated that it might be coronary artery spasm.

1. Fatal coronary artery spasm

Huazi told him that coronary artery spasm refers to the abnormal contraction of the coronary artery due to stimulation for some reason, which leads to narrowing of the arterial lumen, resulting in insufficient blood supply to the myocardium and causing angina pectoris. In severe cases, it can cause complete occlusion of the arterial lumen, causing myocardial infarction, and may also cause malignant arrhythmias and sudden death.

The main cause of coronary heart disease is coronary artery stenosis caused by coronary atherosclerosis. In fact, coronary artery spasm is also a manifestation of coronary heart disease, but its proportion is very low and it is easily overlooked.

Why does coronary artery spasm occur?

All organs of the human body are controlled by the autonomic nervous system, and the heart is no exception. When there are inducements that cause the autonomic nervous system to be overexcited, it is possible to cause the coronary artery to over-contract and spasm. In addition, when the thromboxane A2 that stimulates platelet aggregation increases in the human body, and when the prostacyclin that dilates blood vessels decreases, it is possible to cause coronary spasm.

The cause of coronary spasm has nothing to do with whether or not you have coronary heart disease. However, people with atherosclerosis in the coronary arteries will suffer from chronic myocardial ischemia, which is more likely to induce coronary spasm. In addition, atherosclerotic coronary arteries will have a certain degree of stenosis, which will make spasm more severe and the treatment effect will be poor.

3. People who are prone to coronary artery spasm should be more vigilant

A common cause of coronary spasm is a substance that directly stimulates the coronary artery. For example, during coronary angiography, the stimulation of the catheter or contrast agent can easily induce coronary spasm. Another common stimulus is smoking. Nicotine in tobacco can directly stimulate the endothelium of the blood vessels and cause coronary spasm.

There are also drastic emotional changes, such as rage, excessive sadness, ecstasy, and cold stimulation, which will cause the human body to enter a state of stress, increase the secretion of vasoconstrictive catecholamine hormones, and cause coronary artery spasm.

For women, estrogen can reduce the occurrence of atherosclerosis and protect the cardiovascular system. However, when estrogen levels are too high, it may also cause coronary artery spasm, which mainly occurs in women before menopause.

4. How to prevent and treat coronary artery spasm

Coronary artery spasm is the excessive contraction of the coronary artery, so all drugs that can dilate blood vessels can be used to treat coronary artery spasm. Commonly used drugs are nitrates, which can be taken sublingually in the same way as for the treatment of angina pectoris, when chest pain occurs, to dilate blood vessels and improve symptoms.

Calcium ion antagonists can also be used, including dipine drugs and non-dipine drugs such as diltiazem, which can be used to prevent and treat coronary artery spasm. Lol drugs have a therapeutic effect on angina pectoris caused by coronary heart disease, but are ineffective for coronary artery spasm.

In daily life, we should maintain a healthy lifestyle, including healthy eating, quitting smoking and drinking, controlling emotions, not staying up late, reducing work intensity, etc. People with "three highs" need to control related chronic diseases, which can reduce the possibility of coronary artery spasm.

In summary, coronary artery spasm is also a manifestation of coronary heart disease. Smokers, women, and people with "three highs" chronic diseases should be more vigilant, adhere to a healthy lifestyle, maintain a stable mood, and use medication regularly under the guidance of a doctor for prevention. If you have any questions about medication, please consult a doctor or pharmacist. I am pharmacist Huazi, welcome to follow me and share more health knowledge.