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Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
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Provocative testing for coronary reactivity and spasm

Melody Zaya1, Puja K Mehta1, C Noel Bairey Merz1

  • 1Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, California.

Journal of the American College of Cardiology
|November 9, 2013
PubMed

Insights

Coronary spasm, a cause of chest pain, can lead to serious outcomes like heart attack and death. Provocation testing is crucial for diagnosing this condition, despite diagnostic challenges due to its transient symptoms.

Area of Science:

  • Cardiology
  • Vascular Medicine

Background:

  • Coronary spasm, also known as Prinzmetal's angina, is an underrecognized cause of chest pain.
  • Historically considered benign, it is now linked to severe adverse events, including acute coronary syndrome, arrhythmias, and mortality.

Purpose of the Study:

  • To review published data on the diagnostic utility of provocation testing for coronary spasm.
  • To highlight the importance of identifying coronary spasm as a cause of chest pain.

Main Methods:

  • Systematic review of existing literature on coronary spasm diagnosis.
  • Analysis of data concerning various provocative agents used in testing.

Main Results:

  • Provocation testing plays a vital role in diagnosing coronary spasm.
  • Diagnostic challenges exist due to the transient nature of coronary spasm symptoms.

Conclusions:

  • Coronary spasm is a significant condition with potentially fatal outcomes.
  • Provocative testing is essential for the definitive diagnosis of coronary spasm.

Keywords:
ACHCFRCSERICIVMIPrinzmetal's anginaSCAacetylcholinecoronary flow reservecoronary spasmergonovineintracoronaryintravenousmyocardial infarctionprovocation testingsudden cardiac arrest

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