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Fibromyalgia Action UK
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Prinzmetal Angina (Coronary Artery Spasm)

Morning everyone. Like you, I'm fascinated by this illness which joins us all together. Does anyone here, (apart from me), suffer from Prinzmetal Angina (Coronary Artery Spasm).

It shows itself as crushing chest pain and mimics a heart attack or Angina Pectoris.

It differs from the above two insofar as it does not show on an ECG, (it is not a, 'heart attack'), and there is little or no significant blockage, when examined by an angiogram, unless the cardiologist, having reached a conclusion of, "no angina pectoris", has the knowledge to then stimulate and artificially induce a CAS.

Also, unlike angina pectoris, it is not exercise/exertion related and comes on during periods of rest. It is also of greater time duration than angina pectoris and, if the artry spasms sufficiently, can close off the artery completely, causing instantaneous death.

I've had it all my life. It is one of those unpredictable incidents which can be seperated by weeks, months or even years and it is yet another of those complaints that, if you're dealing with a doctor with insufficient awareness, is diagnosed as, 'stress', 'posture', or, 'It's all in your mind'.

Bearing in mind studies old and new which have linked FM to constant excitation of the , 'fight or flight', response and constant excitaion of the connective ligament fascia, is this another of those FM markers?

My wife tells me, that she has often watched me, when I am asleep or awake and has noticed constant or intermittent twitching at unrelated parts of my body. Is this another piece of the puzzle?

8 Replies

Twitching, spasms in any/every muscle sounds like fm to me. That chest crushing pain, twice I've been 999 to hospital with suspected heart attack. Heart tracings proved not so, and then each time the wave of horrendous pain built and crashed over me, they injected morphine, which gradually brought it under control. Within an hour or so I was back to 'normal' (for me). Does this sound like Coronary Artery Spasm to you?


I'm not a doctor but like most people, I am a member of this forum because we have all found out how little doctors seem to know about FM and many other things.

Most doctors do their job very well, 'within the box', but again, we all know that with ailments, diseases and, 'syndromes', outside of their, 'comfort zone', they are far to ready to go down the path of, "I cant find it, so it's all in your mind or you're faking it to get attention/get time off work/get compensation/get benefits."

We really haven't moved far from, diagnoses of, 'ill humours', 'excess blood', or, 'demonic possession'!.

If you get the crushing pain, you must always, always, call an ambulance. They will carry out an ECG on you, on the spot and if it's not a heart attack, they will tell you.

They will take you to your local hospital, usually but not always, A&E who will carry out another ECG as well as recording your SATS, GCS etc.

If you go to your GP with these symptoms, they may, at some point, start to talk about Angina. At this point it is very important to let your GP know clearly and unequivocally, whether the pain is brought on by exercise or whether it occurs at rest or in bed. Although you aren't going to feel like doing it, either yourself or get a family member or friend to note how long the attack lasts, when it happens.

If your attack is not exercise related and your GP does not raise the topic then I would suggest that you ask them whether they have considered Coronary Artery Spasm / Prinzmetal Angina, as the source of your pain. If you are referred to a Cardiologist and particularly if an Angiogram is being considered, then ask them directly whether after testing for Angina Pectoris, do they intend to test for CAS? I make no broad statements about doctors, particularly Specialists but you may feel it beneficial to take a friend along with you to any such meetings, perhaps to take note of exactly what has been discussed.

There are a lot of good sites out there with information about heart problems.

My favourite is to the Australian Heart Foundation heartfoundation.org.au/

and then follow the link to heartfoundation.org.au/Site... for a simple and readable .pdf document about CAS.

The above is simply my personal view, based on my own experiences. I hope it helps somebody, somewhere. Never, ever however fail to consult, listen to and act on the the advice of trained medical professionals, something which, I again must reiterate, I am not.


I just recently joined the group. I have been diagnosed with CAS. My doctor and I have va been able to control it somewhat with cardizem 120 mg 4 times a day. For the most part it does control it however I have days where nothing seems to help and I walk around with crushing chest pain all day. They noticed a change on my EKG in the ST segment. However they have ruled out heart attack. But still can't explain why the change is there. However when I look back on EKG from 20 years ago it's the same then as. It is now. Even showed my doc. So his best option was to try to control it with medication and increase the medication when it gets worse. There are other options but they save those as a last resort. Like scents as an example. I wish all options you with this issue good luck. It's a pain to live with litterally.


Like you, I was diagnosed with Prinzmetal's Angina; my cardiologist caught CAS during the angiogram and documented it. I got a printout of that documentation and carry it around. I am on Cardizem 120, but because I get the ER (extended release) version, I take only 2 per day. I used to wake up every Sunday and also some other mornings with the crushing chest pain, and my nitroglycerin wouldn't fix it until the third or fourth try. The way I got the number of episodes to decrease was by reviewing every part of my life and slowing down in each area. I knit more, listen to relaxing music, use essential oils for scents and spend my time writing my cookbook with no deadline. I also was told by my cardiologist that conflict must be avoided at all costs; I make sure that I agree with people right away and stay away from everyone who makes me nervous or anxious in any way. When anything looks like it could get me upset, I practice deep breathing and 'let it go' which helps tremendously.


ThankYou Norah for your post above. I had a CAS in 2013 and no one was able to tell me much about it. Like you I decided to destress my life as much as possible (I now practise Zen) but I always worried that conflict/anxiety could cause a reoccurrence. I was glad to read that your specialist advised avoidance at all costs; now I know I have not been making it up! I hope you have remained healthy ever since. ❤️


I am a Fibromyalgia patient and have been experiencing angina like pains for past few years. Only recently the doctors have diagnosed it as possible Coronary spasm.


I suspect because the NHS curtails investigative research via contracts & remits & time restriction many of us [ mainly women in prinzmetals ] are put at risk as the Insurance companies won't let you insure either as preexisting when not diagnosed or treated .This is as same Drs working in private sector refer to themselves for access to research yet not give valid findings often ignoring symptoms & consequence with no Hippocratic oath.I have not had it diagnosed only when nearly fatal given angioplasty then left ? Watchful waiting?!!!

Yet they take money for this knowing had the MI & angioplasty !It has taken 11 yrs to find PAH via Reveal Device [ holter monitors not showing problem] & give diuretics for classic oedema & breathlessness .When it effects function & mobility & all underlying conditions [ trigger points] which NHS ration & discriminate it is not funny as downright dangerous.when it could lead to multi infart dementia which late mother had severely cognitive , movement & function it is not acceptable yet happening .


Hi comber (and everyone else who is reading this), im 19 yerars old, diagnosed with fibromialgya, migranes, and currently being tested for Ehlers - Danlos syndrome. ive been sent to the hospital twice: for the first time with suspiscion for MI, and for the second time with both suspected MI and TIA which lasted for a few days. I had half of my face fallen down and suffered from neurological changes on my left leg. my theory was indeed temporary spasms of my heart and brain blood vescels which caused the situation, although the doctors sent me home with no actual answer.

i was wondering if anyone here might have heared of somthing like that before or knows any better than me?


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