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Retrograde Perfusion and Filling of Mouse Coronary Vasculature as Preparation for Micro Computed Tomography Imaging
Published on: February 10, 2012
Intravascular imaging findings in severe coronary vasospasm
Parham Eshtehardi1, Saurabh S Dhawan, Michael C McDaniel
1Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
Journal of Cardiovascular Medicine (Hagerstown, Md.)
|June 29, 2011
Summary
Diagnosing chest pain without coronary artery disease is difficult. A case study shows acetylcholine infusion can reveal coronary vasospasm, even with normal initial tests, aiding diagnosis.
Area of Science:
- Cardiology
- Diagnostic Medicine
Background:
- Chest pain diagnosis is challenging, especially when coronary angiography shows no significant atherosclerosis.
- Microvascular dysfunction is often considered, but other causes of chest pain persist.
Observation:
- A 65-year-old woman presented with exertional and emotionally triggered chest pain.
- Coronary angiography, intravascular ultrasound, and coronary flow reserve assessments were normal.
- Intracoronary acetylcholine infusion induced epicardial vasoconstriction and chest pain.
Findings:
- Acetylcholine challenge identified coronary vasospasm (variant angina) in a patient with non-obstructive coronary artery disease.
- Markedly increased blood velocity correlated with vasoconstriction and ischemic symptoms.
- Diagnostic utility of acetylcholine infusion in suspected coronary vasospasm is demonstrated.
Implications:
- Considers coronary vasospasm as a critical differential diagnosis in non-obstructive coronary artery disease chest pain.
- Highlights the importance of provocative testing for diagnosing variant angina.
- Suggests acetylcholine infusion is valuable for identifying coronary artery spasm when other tests are inconclusive.
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