What Are Heart Spasms / Non-Obstructive Coronary Artery Disease?

The heart is a muscle that continuously pumps blood to supply oxygen to all the cells of the body. To do this, the heart needs its own reliable blood supply from the large blood vessels (the coronary arteries) and an extensive network of much smaller blood vessels (the microvessels).

During physical and emotional stress, the heart muscle needs more blood. When this does not happen, the heart muscle is starved of oxygen and a person may suddenly feel symptoms of angina.

Coronary Artery Disease (CAD) is defined by angina that is usually caused by a permanent blockage of the coronary arteries. In some individuals, the lack of blood supply to the heart is caused by Non-Obstructive Coronary Artery Disease (NOCAD) such as coronary vasospasm and microvascular dysfunction. In NOCAD, it is thought that the blood vessels of the heart do not work properly due to either temporary vasospasm in the small and large heart arteries or a disorder of the small blood vessels in the heart muscle.

Research is taking place to try to further understand fully why some people experience Vasospastic Angina and Microvascular Angina, as well as how these conditions affect the blood supply to the heart muscle.

Coronary Vasospasm

There are some individuals who experience angina which is not caused by blockages of the coronary arteries. The coronary arteries temporarily constrict during a spasm, reducing the blood supply to the heart.

The spasms are transient, coming and going, sometimes lasting for a few minutes or for much longer. These coronary vasospasms can be unprovoked occurring at rest rather than being brought on by exercise.

Microvascular Angina

Microvascular Angina (MVA) is a type of angina caused when the small blood vessels of the heart (micro vessels) do not work properly.

The micro vessels are important as they supply most of the blood to the whole of the heart muscle. In Microvascular angina, these microvessels either fail to dilate, stay relaxed or constrict in temporary spasms. This is also known as Coronary Microvascular Dysfunction (CMD/CMVD) or now more commonly, Microvascular Dysfunction (MVD).

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