I20.1

Clinical Causes: Coronary artery spasms possibly triggered by smoking, stress, or exposure to cold. Use of certain drugs, such as cocaine or amphetamines. Chronic conditions like hyperreactivity of the coronary smooth muscle. Medication side effects that induce vasoconstriction. Rarely, underlying atherosclerosis may contribute to the spasms.

Key Symptoms: Chest pain or discomfort, often occurring at rest. Pain that may radiate to the arm, neck, jaw, or back. Transient squeezing or tightness sensation in the chest. Episodes typically last a few minutes but can be self-resolving. Occasional symptoms like sweating, shortness of breath, or dizziness during episodes.

Diagnosis Path: Electrocardiogram (ECG) recordings during an episode showing transient ST-segment elevation. Coronary angiography with provocation testing (using agents like ergonovine or acetylcholine) to induce and observe spasms. Exercise stress tests may sometimes be used but are less definitive. Blood tests to evaluate for cardiac enzyme changes, though usually normal during spasms.

Treatment Protocols: Calcium channel blockers to prevent and relieve coronary spasms. Nitrate medications like nitroglycerin for immediate relief during symptoms. Lifestyle modifications, including quitting smoking, managing stress, and avoiding cold exposure. Medications to reduce risk factors for coronary artery disease if present. Monitoring and follow-up with a healthcare provider to adjust treatment plans.