Vasospasm
A sudden narrowing of a blood vessel that limits blood flow
Quick Facts
- Type: Blood vessel disorder
- Effect: Reduced blood flow to tissues
- Common sites: Fingers, heart, brain
- Triggers: Cold, stress, certain conditions
Overview
Vasospasm is a sudden, temporary tightening of the muscle in the wall of a blood vessel, usually an artery. This narrows the vessel and reduces blood flow to the tissues it supplies. The effects depend on where the spasm occurs, ranging from cold, pale fingers to more serious reductions in blood flow to the heart or brain.
Some forms of vasospasm are common and relatively harmless, such as the color changes of the fingers in cold weather. Others can be serious, including spasm of a heart artery causing chest pain, or spasm of brain arteries that can occur after certain types of bleeding in the brain. Treatment depends on the cause and location and often includes medications that relax blood vessels.
Symptoms
Symptoms vary widely depending on which blood vessels are affected:
- Fingers and toes: Color changes (white, then blue, then red), numbness, tingling, and coldness, often triggered by cold or stress.
- Heart arteries: Chest pain or pressure, sometimes at rest or at night, which may feel like angina.
- Brain arteries: Headache, weakness, confusion, difficulty speaking, or other stroke-like symptoms.
Chest pain and stroke-like symptoms are emergencies. Sudden severe chest pain, or sudden weakness, numbness, trouble speaking, or vision loss, require calling emergency services right away.
Causes
Vasospasm happens when the smooth muscle in a vessel wall contracts too strongly. Causes and triggers vary by location:
- Cold and emotional stress: Common triggers for spasm in the fingers and toes.
- Underlying conditions: Such as connective tissue diseases, which can cause repeated finger spasms.
- Coronary artery spasm: Sometimes linked to smoking, certain drugs, or stress.
- Bleeding around the brain: Spasm of brain arteries can follow a type of stroke called subarachnoid hemorrhage.
- Some medications and substances: Including stimulant drugs.
Risk Factors
- Exposure to cold or significant emotional stress
- Smoking, which affects blood vessel tone
- Connective tissue or autoimmune diseases
- Use of stimulant drugs or certain medications
- Recent bleeding around the brain (for cerebral vasospasm)
- A history of migraine or Raynaud-type symptoms
Diagnosis
Diagnosis depends on the suspected site of vasospasm and combines history with targeted tests:
- History and examination: Noting triggers, symptoms, and color changes.
- Heart testing: ECG and, in some cases, specialized angiography to detect coronary artery spasm.
- Brain imaging: CT, MRI, or angiography to assess brain arteries, especially after a hemorrhage.
- Blood tests: To look for underlying conditions such as autoimmune disease.
Treatment
Treatment aims to relax the affected vessels, relieve symptoms, and address the cause:
- Medications that widen vessels: Such as calcium channel blockers, which are used for finger spasm and coronary spasm.
- Avoiding triggers: Keeping warm, managing stress, and stopping smoking for finger and coronary spasm.
- Emergency care: Coronary spasm causing chest pain and cerebral vasospasm are treated urgently in a hospital with specific therapies.
- Treating underlying conditions: Such as managing an autoimmune disease.
The right treatment depends heavily on which vessels are involved and how serious the reduction in blood flow is.
Prevention
Prevention focuses on avoiding triggers and managing risk factors:
- Keeping hands and body warm and wearing gloves in cold weather
- Managing stress with relaxation techniques
- Not smoking and avoiding stimulant drugs
- Taking prescribed medications regularly if you have known vasospasm
- Treating underlying conditions that contribute to spasm
When to See a Doctor
See a doctor if you have repeated episodes of finger color changes, numbness, or coldness, especially if sores develop on the fingertips. Seek emergency care immediately for:
- Sudden, severe chest pain or pressure
- Sudden weakness or numbness, especially on one side
- Trouble speaking, confusion, or sudden vision loss
- A sudden, severe headache unlike any before
Frequently Asked Questions
What is vasospasm?
Vasospasm is a sudden tightening of the muscle in a blood vessel wall that narrows the vessel and reduces blood flow. Its effects depend on the location, from cold, pale fingers to chest pain from a heart artery or stroke-like symptoms from a brain artery. Treatment depends on the cause and site.
Is vasospasm dangerous?
It can range from harmless to serious. Spasm of the fingers in cold weather is usually mild, while spasm of a heart or brain artery can be an emergency. Chest pain and stroke-like symptoms always require immediate medical care.
What triggers vasospasm in the fingers?
Cold exposure and emotional stress are the most common triggers for finger and toe spasm, which causes color changes, numbness, and coldness. Underlying autoimmune or connective tissue diseases can also contribute. Keeping warm and managing stress often reduce episodes.
How is vasospasm treated?
Treatment often includes medications that relax and widen blood vessels, such as calcium channel blockers, along with avoiding triggers like cold and smoking. Serious forms affecting the heart or brain are treated urgently in a hospital. Managing any underlying condition is also important.
When is vasospasm an emergency?
Seek emergency care immediately for sudden severe chest pain, sudden weakness or numbness on one side, trouble speaking, sudden vision loss, or a sudden severe headache. These can indicate spasm affecting the heart or brain, or another serious problem. Prompt treatment can be lifesaving.
References
- National Heart, Lung, and Blood Institute (NHLBI).
- MedlinePlus, U.S. National Library of Medicine. Raynaud's phenomenon.
- American Heart Association. Coronary Artery Spasm.
- Merck Manual Consumer Version.