Coronary Artery Vasospasm

Question: What causes the coronary arteries to undergo vasospasm? Something to do with the formation of a micro thrombis and vasoconstriction? So is vasospasm just short term or can it happen over a longer period of time, for example, due to an obstruction such as a thrombus?

Answer: Spasm is a basic property of the smooth muscle in the walls of the artery. Some individuals have a tendency for vasospasm. It is not definitely linked to micro thrombi. Spasm can occur in the smooth muscle adjacent to a plaque as well as in a healthy region.

Question: Were these symptoms of a heart attack? This past Sunday I suffered what seemed to be a heart attack. During an argument with my teenager I felt a heavy tight feeling on my chest which radiated up towards my neck til my jaw. My head felt full and I was a little dizzy. My fingers were bluish from the tips down to a little past the 2nd knuckle. The bluish fingers came back to normal after about half an hour but the tightness of my chest, neck and jaw, dizziness, and feeling of a "full head" continued for a little over 3 hours. I was in complete denial that I was having any sort of heart related incident. I'm only 29! After speaking with my best friend who is an R.N. and my doctor, I was finally convinced to visit the ER. I was admitted immediately after an EKG. An x-ray was then done. The ER dr then said he wanted to keep me in observation overnight because of risk factors (overweight, family history of heart disease in young adults), an abnormal EKG, and that I had an enlarged heart (x-ray). During observation they drew blood numerous times. Later on that very early morning during observation they said my enzymes were negative but that they wanted to keep me to do a stress test in the morning. Prior to doing that they then said they wanted to admit me. During my 3 day stay at the hospital I did a stress test, a nuclear ractive test (?), and an echocardiogram. I was in the hospital for three days, was discharged by the nurse via doctor's orders. I was astonished that I was being released from the hospital without any of my test results or a conversation with the doctor. The nurse called the doctor who refused to speak with me on the phone because he was in his private office. What could this have been? Was it a heart attack? Could I have had a minor heart attack previously, and already damaged heart and that's why the enzymes were negative? Would a coronary artery spasm, prinzmetals, vasospasm, variant angina all come up positive enzymes? If it wasn't a heart attack what would explain the tight heavy feeling? What would explain the blue fingers? If it was indeed nothing serious why did they keep me for 3 days? That's the part that scares me most. Some more info: No my fingers were not tingling. I'm latin so I talk with my hands. I stopped at mid sentence when I saw my fingers were blue.

Answer: it definately isnt a heart attack cos a heart attack is much more severe with breathlessness, and pain so bad you think you might die. You just brushed it off. it doesnt sound to me like its angina either though... im not sure... ? It could be variant because variant angina is basically a sensitivity of your blood vessels to constriction: which would explain your blue fingers. However, if you smoke, are obese, have high cholesterol, have low exercise... then it could be angina. I know its unlikely because of your age, but i know someone your age who had a stroke. The tests shouldnt take too long to come back though. Bug them about it sounds like they are being lazy about it. In regard to your question, im geussing that cardiac enzymes do not exclude the fact that it could well be angina, let alone an MI: i dont believe any test is 100% sensitive or specific so.... also, it could have been something called hyperventilatory syndrome in which you blow off too much carbon dioxide when you are anxious and this causes a tingling sensation in the fingers. Did you have this?