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Updated: Aug 10, 2026

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
Published on: August 18, 2016
Refractory vasomotor angina in subclinical hyperthyroidism demonstrating focal and segmental coronary
Allison DeTommasi1, Scott Rogge, Jan Laws Houghton
1Academic Director of Interventional Cardiology, Division of Cardiology, A-44, Albany Medical College, New Scotland Avenue, Albany, NY 12208, USA.
Abstract:
We describe a case of refractory vasomotor angina in the setting of unrecognized subclinical hyperthyroidism. Despite aggressive medical therapy, frequent rest angina recurred until diagnosis and treatment of Grave s Disease, which presented asymptomatically. Both spontaneous focal vasospasm and inducible segmental coronary vasoconstriction were demonstrated during invasive provocative testing. Subclinical hyperthyroidism should be considered in the differential diagnosis when treating refractory vasomotor angina, especially in women over 50 years old, a population at particular risk for undiagnosed thyroid disease.
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