Dr.S.Venkatesan MD

Both  entities   refer  to contraction of vascular smooth muscle.Vascular smooth muscle tone  is under the control of autonomic neuro and humoral system.

Local mechanical , stretch  receptors also  play a role .( local temperature -Cold vasoconstriction  , warmth relieves it ) Abnormal elevated  vascular  tone occur in pathological situations ( Vascular interventions, surgery , drugs, extreme cold ,   )

Both terms are closely related often used interchangeably .There are some subtle differences though , mainly in the usage pattern.

Vasospasm

Is generally a   regional   phenomenon implying central mechanisms  are less  operative.

A local  trigger mechanical or biochemical .( Even a mechanical drag can cause a spasm

It is often transient .

Occurs primarily in small , medium blood vessels .(I  wonder whether  Aorta can go for  spasm !)

Clinical examples

• Catheter induced vasomotor in cath lab (Radial spasm)
• Spasm associated with plaque  Prinzmetal angina
• Cerebral vessel spasm after sub arachnoid hemorrhage ( Need not be transient )

Vasoconstriction

This is also result in  constriction of blood vessels

But the blood vessels involved  are in  micro circulation like capillaries and arterioles .

Often sustained (If transient does it become vasospasm ?)

Vasoconstriction  often involves wide areas and may result in elevated regional or systemic vascular resistance . Hence  it often  result in elevated  blood pressure.

Clinical example

• Normal Blod pressure  regulation y autonomic mediated vasoconstriction
• Arteriolar  constriction with Nor adrenaline , dopamine .
• Capillary Vasoconstriction  due to cold (Raynaud phenomenon )

* Please note other terms like vascular tone , vasomotion   closely competes with above .

Final message

Most of the confusion in medical terminologies are man-made.Both vasospasm and vasoconstriction are  often used  interchangeably .It  is ideal to use  the former for a transient , localised response  in large caliber vessel , and the latter when it occurs as  a general response to altered autonomic  tone and  involve the micro vasculature.