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Narrowing of the blood vessels to the heart is the main cause of angina. This narrowing is usually the result of plaque buildup in the arteries, but it can be the result of a coronary artery spasm. When this happens, the angina is called variant angina. Use of cocaine, nicotine, and amphetamines can cause coronary artery spasms, and sometimes they are caused by other diseases such as lupus.
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