Related Experiment Video
Updated: Aug 15, 2026

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
Published on: August 18, 2016
Vasospastic angina pectoris associated with Churg-Strauss syndrome
Paraskevi Petrakopoulou1, Wolfgang M Franz, Peter Boekstegers
1Department of Cardiology, University Hospital Munich, Grosshadern, Germany.
Background:
A 50-year-old woman presented with recurrent episodes of unstable angina pectoris refractory to vasodilator treatment. Relevant coronary stenoses were excluded by coronary angiography and intravascular ultrasonography. Intracoronary infusion of acetylcholine revealed diffuse coronary vasospasms associated with clinical signs of myocardial ischemia and ST-segment elevation. Symptoms of bronchial asthma, polyneuropathy, nasal polyps, allergic rhinitis, gastritis and eosinophilia led to a diagnosis of Churg-Strauss syndrome.
Investigations:
Serum chemistry, coronary angiography, left-heart catheterization, intravascular ultrasonography and coronary vasospasm provocation with acetylcholine.
Diagnosis:
Vasospastic angina pectoris associated with Churg-Strauss syndrome.
Management:
Treatment with systemic corticosteroids and cyclophosphamide.
Related Concept Videos
Angina II: Classification
Angina III: Clinical Manifestations and Assessment
Angina I: Introduction
Esophageal Achalasia
Aneurysm II: Clinical Manifestations and Diagnostic Studies
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

