Suspected Microvascular Coronary Spasm Diagnosed by Spasm Provocation Test with High Dose of Acetylcholine
Shigenori Ito
Division of Cardiology, Nagoya City East Medical Center, Japan
Tatsuya Mizoguchi
Division of Cardiology, Nagoya City East Medical Center, Japan
*Author to whom correspondence should be addressed.
Abstract
A 71-year-old Japanese man was admitted to our hospital complaining of chest oppression on exercise, such as cycling uphill, which had continued for 9 years. We diagnosed him as having microvascular spasm according to the results of coronary angiography with an acetylcholine provocation test with a high dose (150mg) of acetylcholine administrated at a time during 20 seconds. Electrocardiographic changes during the spasm provocation test resembled that during exercise tests performed upon admission and 9 years previously. He was treated with a calcium channel blocker and partial symptom relief was obtained.
Keywords: Coronary vasospasm, microvascular dysfunction, cardiac syndrome X, acetylcholine, exercise