A heart spasm, medically known as a coronary artery spasm or Prinzmetal’s angina, involves a sudden, temporary narrowing of one of the coronary arteries. These arteries deliver oxygen-rich blood to the heart muscle. This temporary tightening restricts blood flow, causing a transient episode of chest pain. The experience reflects reduced oxygen supply to the heart muscle.
The Distinct Sensation of a Heart Spasm
The sensation of a heart spasm is most often described as intense chest discomfort that comes on abruptly. This feeling is located deep behind the breastbone, known as the substernal area. Patients frequently use words like squeezing, crushing, or heavy pressure to characterize the pain.
This severe discomfort can spread outward from the center of the chest. It commonly radiates to other areas of the upper body, including the jaw, the neck, and the left arm or shoulder. Sometimes, the pain may be felt in the back or the upper abdomen, occasionally mimicking severe indigestion or heartburn.
The severity of the pain can vary widely, but it is typically pronounced. This intense feeling of tightness or pressure is the primary symptom that causes immediate alarm. The pain is a direct consequence of the heart muscle being briefly deprived of sufficient oxygen due to arterial narrowing.
Typical Patterns and Triggers
Coronary artery spasms have a distinct pattern that often distinguishes them from other types of chest pain. A characteristic feature is that episodes often occur when a person is at rest, rather than during physical exertion. Many individuals experience these spasms specifically during the night or in the early morning hours, often waking them from sleep.
The duration of the pain is typically short-lived, with episodes commonly lasting five to thirty minutes. The pain usually resolves spontaneously as the artery wall relaxes and blood flow is restored. This transient nature is a hallmark of the condition, though spasms can sometimes occur in clusters.
A variety of factors can trigger a spasm in susceptible individuals. Exposure to cold temperatures, such as cold weather or swimming in cold water, is one trigger. High levels of emotional stress can also contribute to an episode, as can the use of substances like nicotine or recreational stimulant drugs.
Differentiating Spasm Pain from a Heart Attack
Distinguishing the pain of a heart spasm from a heart attack can be challenging because the sensation often overlaps. Both conditions can involve severe pressure, squeezing, or tightness in the chest, sometimes radiating to the jaw or arm. However, the circumstances surrounding the pain and its response to medication provide differentiating factors.
Pain from a heart attack, caused by a persistent blockage from plaque buildup, is frequently triggered by physical exertion or emotional stress. Conversely, a heart spasm is known to occur while a person is resting, and the pain is rarely brought on by activity. Heart attack pain also tends to be more prolonged, generally lasting longer than 30 minutes.
Another distinction is the response to nitroglycerin, a medication used to relax blood vessels. Pain from a heart spasm often responds quickly and effectively to nitroglycerin, providing rapid relief within minutes. While symptoms can feel identical, the rapid onset at rest and quick resolution are more indicative of a spasm. Despite these differences, the symptoms of both conditions can overlap significantly, meaning self-diagnosis is not reliable.
When to Seek Emergency Medical Care
Any new, severe, or unexplained chest pain should be treated as a medical emergency until a healthcare professional determines the cause. The overlap in symptoms between a heart spasm and a heart attack makes immediate medical evaluation necessary. It is never advisable to wait for the pain to resolve on its own if the cause is unknown.
Contact emergency medical services immediately if chest pain lasts longer than a few minutes, typically five minutes. This is especially urgent if the pain is accompanied by other concerning symptoms. These red flags include sudden shortness of breath, lightheadedness, nausea, or breaking out into a cold sweat.
Seeking immediate professional help ensures that life-threatening conditions, such as a heart attack, can be rapidly diagnosed and treated. Even if the cause is determined to be a heart spasm, the event itself can sometimes lead to serious heart rhythm disturbances. Prompt medical attention is the safest course of action for any severe chest discomfort.