Coronary artery spasm is a cause of inadequate oxygen levels (ischemia) of the heart. It affects approximately 4 out of 100,000 people, and affects approximately 2% of patients with angina. The arteries affected may be normal but much more often, they are "hardened" (atherosclerotic). Spasm may be "silent" -- without symptoms -- or it may result in stable angina or unstable angina. The most typical manifestation of coronary spasm is variant angina (see below). Prolonged spasm may even cause a heart attack. Coronary artery spasm may occur spontaneously, or it may be caused by exposure to cold, emotional stress, alcohol withdrawal, or vasoconstricting medications. Cocaine use and cigarette smoking can cause severe spasm of the arteries while at the same time increasing the energy requirements of the heart. Variant angina is a type of chest pain, probably involving coronary artery spasm, where the angina pain is triggered by rather unusual factors. It most often affects women under 50, but can also affect men.
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