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Updated: Jun 11, 2026

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
Published on: August 18, 2016
A case of cardiac cephalalgia showing reversible coronary vasospasm on coronary angiogram
Youngsoon Yang1, Dushin Jeong, Dong Gyu Jin
1Department of Neurology, Hyoja Geriatric Hospital, Yongin, Korea.
Background:
Under certain conditions, exertional headaches may reflect coronary ischemia.
Case Report:
A 44-year-old woman developed intermittent exercise-induced headaches with chest tightness over a period of 10 months. Cardiac catheterization followed by acetylcholine provocation demonstrated a right coronary artery spasm with chest tightness, headache, and ischemic effect of continuous electrocardiography changes. The patient's headache disappeared following intra-arterial nitroglycerine injection.
Conclusions:
A coronary angiogram with provocation study revealed variant angina and cardiac cephalalgia, as per the International Classification of Headache Disorders (code 10.6). We report herein a patient with cardiac cephalalgia that manifested as reversible coronary vasospasm following an acetylcholine provocation test.
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