Korean Circ J.  1991 Oct;21(5):842-848. 10.4070/kcj.1991.21.5.842.

A Comparative Study of Acetylcholine and Ergonovine Provocative Test in Patients with Chest Pain Syndrome with Normal or Near Normal Coronary Arteriograms

• Park SW
• Park SJ
• Kim JJ
• Song JK
• Seong IW
• Lee SJ

• KMID: 2093313
• DOI: http://doi.org/10.4070/kcj.1991.21.5.842

Abstract

Intracoronary acetylcholine and intravenous ergonovine tests have been used to induce coronary artery spasm. To evaluate the usefulness of these provocative tests, acetylcholine and ergonovine tests were performed in 86 patients with normal or near normal coronary angiograms(clinically variant angina in 30, effort angina in 6, unstable angina in 5, myocardial infarction in 6, atypical chest pain in 39 patients). Acetylcholine was injected into each coronary artery in incremental doses (0.02, 0.05 and 0.1 mg into left coronary artery, 0.02 and 0.05 mg into right coronary artery) and ergonovin was given intravenously in graded doses of 0.05, 0.1 and 0.2 mg after completion of acetylcholine test. The results were as follow : 1) Among 86 patients, both acetylcholine and ergonovine tests were positive in 29 patients, both tests were negative in 50 patients, and acetylcholine test was positive but ergonovine test was negative in 7 patients ; The responses of acetylcholine and ergonovine tests were concordant in 92% of patients. The sensitvity and specificity of the acetylcholine test with reference to ergonovine test were 100% and 88% respectively. 2) In 7 patients(8%) acetylcholine test was positive but ergonovine test was negative, and this group may represent a spectrum of coronary spasm syndrome.
CONCLUSION
Acetylcholine test is a safe and useful provocative test for coronary artery spasm, especially in the multivessel spasm.

Keyword

Coronary artery spasm; Acetylcholine; Ergonovine

MeSH Terms

Acetylcholine*
Angina, Unstable
Chest Pain*
Coronary Vessels
Ergonovine*
Humans
Myocardial Infarction
Sensitivity and Specificity
Spasm
Thorax*
Acetylcholine
Ergonovine